Provider Demographics
NPI:1326051384
Name:PACIFICO, PAZ MOVIDO (MD)
Entity Type:Individual
Prefix:
First Name:PAZ
Middle Name:MOVIDO
Last Name:PACIFICO
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3288 ARROYO DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-7206
Mailing Address - Country:US
Mailing Address - Phone:707-422-4031
Mailing Address - Fax:
Practice Address - Street 1:1600 CALIFORNIA DRIVE
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95696
Practice Address - Country:US
Practice Address - Phone:707-449-6582
Practice Address - Fax:707-453-7015
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA0394002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E24970Medicare UPIN