Provider Demographics
NPI:1306197611
Name:RECALDE, VIOLETA MILLER (MD)
Entity Type:Individual
Prefix:MRS
First Name:VIOLETA
Middle Name:MILLER
Last Name:RECALDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:VIOLETA
Other - Last Name:RECALDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1680 E 120TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059
Mailing Address - Country:US
Mailing Address - Phone:424-338-8000
Mailing Address - Fax:424-338-8962
Practice Address - Street 1:1680 E 120TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059
Practice Address - Country:US
Practice Address - Phone:424-338-8000
Practice Address - Fax:424-338-8962
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132599207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine