Provider Demographics
NPI:1245086065
Name:CORONADO, AIRAM SUSEJ
Entity type:Individual
Prefix:
First Name:AIRAM
Middle Name:SUSEJ
Last Name:CORONADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W GABILAN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2762
Mailing Address - Country:US
Mailing Address - Phone:841-272-8187
Mailing Address - Fax:
Practice Address - Street 1:130 W GABILAN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2762
Practice Address - Country:US
Practice Address - Phone:841-272-8187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist