Basic Information
| Provider Information | |||||||||
| NPI: | 1003022120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VIEIRA | ||||||||
| FirstName: | MAUREEN | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 W COOLIDGE AVE | ||||||||
| Address2: | |||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953504447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095775005 | ||||||||
| FaxNumber: | 2095211533 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 W COOLIDGE AVE | ||||||||
| Address2: | |||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953504447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095775005 | ||||||||
| FaxNumber: | 2095211533 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 05/04/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | E25237 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.