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General NPI Number Information
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NPI Number | 1316145303
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Entity Type | Individual
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Provider Name | NEIL JOHN CORREIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 562 CAMINO MERCADO
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-1815
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Country | US
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Telephone | 805-410-8971
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Fax | 805-291-8003
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Provider Business Mailing Address
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Address Line | 122 PEARWOOD AVE
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-2910
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Country | US
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Telephone | 805-540-1306
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Fax | 805-434-9413
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101244057
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A111405
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License Number State | CA
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