Provider Demographics
NPI:1922536721
Name:ESTRADA, PAMELA VICTORIA (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:VICTORIA
Last Name:ESTRADA
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 1:1514 VALLEY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3929
Mailing Address - Country:US
Mailing Address - Phone:909-860-1144
Mailing Address - Fax:
Practice Address - Street 1:1514 VALLEY VISTA DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-3929
Practice Address - Country:US
Practice Address - Phone:909-860-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA172320207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology