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General NPI Number Information
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NPI Number | 1932264645
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Entity Type | Individual
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Provider Name | JOSE LUIS PINEDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3300 NW EXPRESSWAY ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4418
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Country | US
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Telephone | 405-949-6051
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Fax | 405-949-6977
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Provider Business Mailing Address
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Address Line | 3300 NW EXPRESSWAY ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4418
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Country | US
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Telephone | 405-949-6051
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Fax | 405-949-6977
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 11563
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License Number State | OK
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