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NPI Code Detail

MEDICARE: DR. CYNTHIA M PERALTA M.D.

MEDICARE: DR. CYNTHIA M PERALTA 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
1208000000XPediatrics PhysicianA49144CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578596698
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CYNTHIA M PERALTA M.D.
Provider Business Mailing Address
First Line : 1300 S SUNSET AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3342
Country : US
Telephone Number : 626-960-6999
Fax Number : 626-960-7331
Provider Business Practice Location Address
First Line : 1300 S SUNSET AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3342
Country : US
Telephone Number : 626-960-6999
Fax Number : 626-960-7331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 11/22/2011

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