Provider Demographics
NPI:1457415879
Name:DEL PILAR, OLIVA ENRIQUEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVA
Middle Name:ENRIQUEZ
Last Name:DEL PILAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OLIVA
Other - Middle Name:ENRIQUEA
Other - Last Name:LANDICHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1501 CLAUS RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9711
Mailing Address - Country:US
Mailing Address - Phone:209-557-6300
Mailing Address - Fax:
Practice Address - Street 1:1501 CLAUS RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9711
Practice Address - Country:US
Practice Address - Phone:209-557-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA758892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH55134Medicare UPIN