Provider Demographics
NPI:1942361332
Name:PLEITEZ, NURIA F (MD)
Entity Type:Individual
Prefix:DR
First Name:NURIA
Middle Name:F
Last Name:PLEITEZ
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 1:430 W BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1829
Mailing Address - Country:US
Mailing Address - Phone:626-859-2851
Mailing Address - Fax:626-859-0341
Practice Address - Street 1:430 W BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1829
Practice Address - Country:US
Practice Address - Phone:626-859-2851
Practice Address - Fax:626-859-0341
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40248208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A402481Medicaid
CA00A402481Medicaid