Healthcare Provider Details

I. General information

NPI: 1447290432
Provider Name (Legal Business Name): SIGFREDO ACOSTA-PEREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SIGFREDO P. ACOSTA MD

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 03/07/2023
Certification Date: 01/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 PEPPER DR APT D
HANFORD CA
93230-7024
US

IV. Provider business mailing address

593 PEPPER DR APT D
HANFORD CA
93230-7024
US

V. Phone/Fax

Practice location:
  • Phone: 321-795-2067
  • Fax:
Mailing address:
  • Phone: 321-795-2067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 64632
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG89403
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: