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General NPI Number Information
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NPI Number | 1942283072
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Entity Type | Individual
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Provider Name | CARMELITA FELICIANO CRISTOBAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 1820 41ST AVE SUITE D
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City | CAPITOLA
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State | CA
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Zip | 95010-2516
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Country | US
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Telephone | 831-476-3000
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Fax | 831-476-9009
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Provider Business Mailing Address
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Address Line | 3000 Q ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-7058
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Country | US
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Telephone | 916-733-5701
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Fax | 916-859-1671
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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 | 33358
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C53347
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License Number State | CA
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