=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982133930
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ISABEL CRISTINA VALLECILLO-VIEJO MD, PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2017
-----------------------------------------------------
Last Update Date | 06/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | NATIONAL INSTITUTES OF HEALTH 9000 ROCKVILLE PIKE, 10 CENTER DRIVE
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20892
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-761-7685
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | NATIONAL INSTITUTES OF HEALTH 9000 ROCKVILLE PIKE, 10 CENTER DRIVE
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20892
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-761-7685
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080P0201X
-----------------------------------------------------
Taxonomy Name | Pediatric Allergy/Immunology Physician
-----------------------------------------------------
License Number | MD210011543
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------