Provider Demographics
NPI:1942569223
Name:VIEIRA, MARCUS AURELIO LEAL (DO)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:AURELIO LEAL
Last Name:VIEIRA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 IRMA STREET
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-2611
Mailing Address - Country:US
Mailing Address - Phone:408-646-3160
Mailing Address - Fax:
Practice Address - Street 1:307 IRMA ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-2611
Practice Address - Country:US
Practice Address - Phone:408-646-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043703207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology