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General NPI Number Information
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NPI Number | 1255400248
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Entity Type | Individual
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Provider Name | RAIMEL YTURRALDE PEREZ-PASILIAO M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 12574 CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710-3507
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Country | US
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Telephone | 909-627-7433
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Fax | 562-365-3532
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Provider Business Mailing Address
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Address Line | 7940 SERENITY FALLS RD
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City | CORONA
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State | CA
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Zip | 92880-3396
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Country | US
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Telephone | 626-674-5284
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Fax | 562-365-3532
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A86687
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License Number State | CA
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