Provider Demographics
NPI:1851353122
Name:PARAGAS, NORMA VELASCO (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:VELASCO
Last Name:PARAGAS
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 1:6275 THORNTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3731
Mailing Address - Country:US
Mailing Address - Phone:510-791-7014
Mailing Address - Fax:510-791-1743
Practice Address - Street 1:6275 THORNTON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3731
Practice Address - Country:US
Practice Address - Phone:510-791-7014
Practice Address - Fax:510-791-1743
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37258208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37258OtherM.D.LICENSE NUMBER
CA222300942OtherTAX IDENTICATION NUMBER