Healthcare Provider Details

I. General information

NPI: 1356561880
Provider Name (Legal Business Name): MARY M. NAVE MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 POSADA LN SUITE A
TEMPLETON CA
93465-4057
US

IV. Provider business mailing address

262 POSADA LN SUITE A
TEMPLETON CA
93465-4057
US

V. Phone/Fax

Practice location:
  • Phone: 805-434-3737
  • Fax: 805-434-1138
Mailing address:
  • Phone: 805-434-3737
  • Fax: 805-434-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY NAVE
Title or Position: PRESIDENT
Credential: MD
Phone: 805-434-3737