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NPI Code Detail

MEDICARE: MARGOT GLYN ELIARDA JUAN

MEDICARE: MARGOT GLYN ELIARDA JUAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1487504189
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGOT GLYN ELIARDA JUAN
Provider Business Mailing Address
First Line : 2124 SANTA ANA DR APT 20
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-3285
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2570 48TH ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1541
Country : US
Telephone Number : 916-734-2145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ MARGOT GLYN ELIARDA JUAN ” Practice Location

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