Provider Demographics
NPI:1073570834
Name:CUNANAN, MARIA EMILIA PEREZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA EMILIA
Middle Name:PEREZ
Last Name:CUNANAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:PEREZ-CUNANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:392 N. PEARSON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3368
Mailing Address - Country:US
Mailing Address - Phone:559-781-6900
Mailing Address - Fax:559-781-6902
Practice Address - Street 1:392 N. PEARSON AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3368
Practice Address - Country:US
Practice Address - Phone:559-781-6900
Practice Address - Fax:559-781-6902
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA83595OtherCA LICENSE NUMBER
CAI02324Medicare UPIN
CA00A835951Medicare PIN