Basic Information
Provider Information
NPI: 1871502344
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUEVAS
FirstName: MAXIMILIANO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19505 REDDING DR
Address2:  
City: SALINAS
State: CA
PostalCode: 939089672
CountryCode: US
TelephoneNumber: 8314551312
FaxNumber:  
Practice Location
Address1: 950 CIRCLE DR
Address2:  
City: SALINAS
State: CA
PostalCode: 939052150
CountryCode: US
TelephoneNumber: 8317576237
FaxNumber: 8317578458
Other Information
ProviderEnumerationDate: 08/05/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XG50921CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
00G50921105CA MEDICAID


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