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General NPI Number Information
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NPI Number | 1568903508
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER FOR DIABETES & METABOLIC CARE INC.
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 1361 BRENTWOOD RD
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City | YARDLEY
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State | PA
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Zip | 19067-3924
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Country | US
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Telephone | 650-808-7430
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Fax | 866-258-6628
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Provider Business Mailing Address
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Address Line | 1361 BRENTWOOD RD
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City | YARDLEY
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State | PA
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Zip | 19067-3924
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Country | US
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Telephone | 650-808-7430
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Fax | 866-258-6628
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Authorized Official
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Title or Position | OWNER
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Name | DR. MYRNA LOPEZ SORIANO
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Credential | M.D.
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Telephone | 650-808-7430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A38854
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License Number State | CA
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