Healthcare Provider Details

I. General information

NPI: 1013961572
Provider Name (Legal Business Name): MARGARET MALIG NONATO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 05/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2290 SACRAMENTO ST
VALLEJO CA
94590-2929
US

IV. Provider business mailing address

2290 SACRAMENTO ST
VALLEJO CA
94590-2929
US

V. Phone/Fax

Practice location:
  • Phone: 707-643-5785
  • Fax: 707-643-8810
Mailing address:
  • Phone: 707-643-5785
  • Fax: 707-643-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA18331
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: