Provider Demographics
NPI:1558361139
Name:PUIG PALOMAR, MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:
Last Name:PUIG PALOMAR
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 1:1430 ESPLANADE #10
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926
Mailing Address - Country:US
Mailing Address - Phone:530-894-3278
Mailing Address - Fax:530-894-3613
Practice Address - Street 1:1430 ESPLANADE #10
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-894-3278
Practice Address - Fax:530-894-3613
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH52642086S0129X
CAA48591208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A485910Medicaid
CA00A485910Medicaid
CAG46131Medicare UPIN