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General NPI Number Information
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NPI Number | 1952670341
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Entity Type | Organization
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Legal Business Name | ANNETTE A CORONEL-PEREY MD INC
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 1045 W REDONDO BEACH BLVD SUITE 100
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City | GARDENA
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State | CA
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Zip | 90247-4128
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Country | US
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Telephone | 310-532-5558
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 W REDONDO BEACH BLVD SUITE 100
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City | GARDENA
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State | CA
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Zip | 90247-4128
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Country | US
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Telephone | 310-532-5558
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. ANNETTE A. CORONEL-PEREY
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Credential | M.D.
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Telephone | 310-532-5558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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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 | A55253
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License Number State | CA
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