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General NPI Number Information
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NPI Number | 1942485313
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Entity Type | Organization
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Legal Business Name | FELICIANO NAVALTA JR., M.D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 16660 PARAMOUNT BLVD SUITE 306
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City | PARAMOUNT
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State | CA
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Zip | 90723-5433
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Country | US
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Telephone | 562-633-1404
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Fax | 562-633-3036
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Provider Business Mailing Address
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Address Line | 16660 PARAMOUNT BLVD SUITE 306
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City | PARAMOUNT
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State | CA
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Zip | 90723-5433
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Country | US
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Telephone | 562-633-1404
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Fax | 562-633-3036
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Authorized Official
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Title or Position | PHYSICAN
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Name | DR. FELICIANO SISON NAVALTA JR.
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Credential | M.D.
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Telephone | 562-633-1404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A25135
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License Number State | CA
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