MEDICARE: MRS. MARIA DE LOS ANGELES OSEGUERA M.D.

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
1	207Q00000X	Family Medicine Physician	G79997	CA

General Provider Information

NPI Number	:	1487627907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA DE LOS ANGELES OSEGUERA M.D.

Provider Business Mailing Address
First Line	:	2452 FENTON ST
Second Line	:	SUITE 301
City	:	CHULA VISTA
State	:	CA
Zip	:	91914-3599
Country	:	US
Telephone Number	:	619-946-4073
Fax Number	:	619-946-7243

Provider Business Practice Location Address
First Line	:	653 EL PORTAL DR
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91914-4109
Country	:	US
Telephone Number	:	619-934-2229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	05/15/2014

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