Provider Demographics
NPI:1083894315
Name:NIEVES, DELMA JULIETA (MD)
Entity Type:Individual
Prefix:
First Name:DELMA
Middle Name:JULIETA
Last Name:NIEVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 S MAIN ST
Mailing Address - Street 2:PSF CREDENTIALING
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3874
Mailing Address - Country:US
Mailing Address - Phone:714-289-4511
Mailing Address - Fax:714-204-3212
Practice Address - Street 1:455 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3874
Practice Address - Country:US
Practice Address - Phone:714-532-8403
Practice Address - Fax:714-289-4014
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87032208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases