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General NPI Number Information
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NPI Number | 1962494153
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Entity Type | Individual
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Provider Name | MARITA AILEEN NOGUERA OBENZA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 08/31/2025
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Provider Practice Location Address
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Address Line | 1344 W CLINTON AVE
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City | FRESNO
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State | CA
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Zip | 93705-3805
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Country | US
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Telephone | 877-960-3426
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 840359
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City | HOUSTON
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State | TX
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Zip | 77284-0359
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Country | US
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Telephone | 832-548-5000
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Fax |
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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 | C203774
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License Number State | CA
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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 | N1805
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License Number State | TX
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