Provider Demographics
NPI:1275935017
Name:PERONEL, MAGDA (NMD)
Entity Type:Individual
Prefix:MS
First Name:MAGDA
Middle Name:
Last Name:PERONEL
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 COYLE AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6333
Mailing Address - Country:US
Mailing Address - Phone:916-850-2959
Mailing Address - Fax:844-667-7642
Practice Address - Street 1:6620 COYLE AVE STE 400
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6333
Practice Address - Country:US
Practice Address - Phone:916-850-2959
Practice Address - Fax:844-667-7642
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath