MEDICARE: VANESSA MARIA NAVARRO 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	A113624	CA

General Provider Information

NPI Number	:	1952563421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA MARIA NAVARRO M.D.

Provider Business Mailing Address
First Line	:	2400 E 8TH ST
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2956
Country	:	US
Telephone Number	:	619-662-4100
Fax Number	:	619-259-2806

Provider Business Practice Location Address
First Line	:	2400 E 8TH ST
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2956
Country	:	US
Telephone Number	:	619-662-4100
Fax Number	:	619-259-2806

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

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	12/16/2013

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