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General NPI Number Information
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NPI Number | 1194947200
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Entity Type | Organization
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Legal Business Name | A.M. PALANCA-CAPISTRANO,M.D. INC.
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 720 MAGNOLIA AVENUE SUITE A-4
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 951-372-9227
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Fax | 951-372-9005
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Provider Business Mailing Address
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Address Line | 19069 VAN BUREN BLVD STE. 114-219
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City | RIVERSIDE
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State | CA
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Zip | 92508-9169
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Country | US
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Telephone | 951-372-9227
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Fax | 951-372-9005
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGELITA M. PALANCA-CAPISTRANO
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Credential | M.D.
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Telephone | 951-372-9227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A91568
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License Number State | CA
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