Provider Demographics
NPI:1477868917
Name:ALTAMIRANO, HUGO ESTEFANO (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGO
Middle Name:ESTEFANO
Last Name:ALTAMIRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 LILLARD DR
Mailing Address - Street 2:165
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-4844
Mailing Address - Country:US
Mailing Address - Phone:917-541-5541
Mailing Address - Fax:
Practice Address - Street 1:2000 VALE RD
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3808
Practice Address - Country:US
Practice Address - Phone:510-970-5253
Practice Address - Fax:510-970-5746
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA121792207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology