Healthcare Provider Details

I. General information

NPI: 1538392642
Provider Name (Legal Business Name): CARMELA ELAINE SOSA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMELA ELAINE UNGUEZ M.D.

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # MB01
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6425
  • Fax: 559-353-6441
Mailing address:
  • Phone: 559-353-6425
  • Fax: 559-353-6441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA95150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: