Provider Demographics
NPI:1487627907
Name:OSEGUERA, MARIA DE LOS ANGELES (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DE LOS ANGELES
Last Name:OSEGUERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 FENTON ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-3599
Mailing Address - Country:US
Mailing Address - Phone:619-946-4073
Mailing Address - Fax:619-946-7243
Practice Address - Street 1:653 EL PORTAL DR
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4109
Practice Address - Country:US
Practice Address - Phone:619-934-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine