Provider Demographics
NPI:1346504164
Name:PINEDA, JOSE ANDRES
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:ANDRES
Last Name:PINEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263-1917
Mailing Address - Country:US
Mailing Address - Phone:661-910-2361
Mailing Address - Fax:
Practice Address - Street 1:450 SHAW AVE
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263-1917
Practice Address - Country:US
Practice Address - Phone:661-910-2361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver