Provider Demographics
NPI:1225242753
Name:DE PERIO, DELIA GAY (OMD, LAC, RN)
Entity Type:Individual
Prefix:MS
First Name:DELIA
Middle Name:GAY
Last Name:DE PERIO
Suffix:
Gender:F
Credentials:OMD, LAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:15079 GOLDENWEST ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2710
Mailing Address - Country:US
Mailing Address - Phone:714-351-1591
Mailing Address - Fax:
Practice Address - Street 1:15079 GOLDENWEST ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2710
Practice Address - Country:US
Practice Address - Phone:714-891-0999
Practice Address - Fax:714-898-7638
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9909171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist