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General NPI Number Information
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NPI Number | 1013597988
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Entity Type | Individual
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Provider Name | DR. ARELY YANIRA MACIAS
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Gender | Female
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 9279 LOCUST ST
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City | PLYMOUTH
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State | CA
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Zip | 95669-9019
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Country | US
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Telephone | 92-456-9682
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Fax | 209-245-5135
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A191863
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License Number State | CA
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