# MIGUEL G. DE PERIO M.D. INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558717686
- **Authorized official:** DR. MIGUEL G DE PERIO (OWNER/PRESIDENT)
- **Authorized official phone:** (949) 463-4004

## Contact information

- **Practice address:** 14476 ALDER DR, CORONA, CA 92880-3517
- **Practice address phone:** (949) 463-4004
- **Mailing address:** 14476 ALDER DR, CORONA, CA 92880-3517
- **Mailing address phone:** (949) 463-4004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A43710 | CA | Yes |

## Other

- **Enumeration date:** 05/07/2016
- **Last updated:** 05/07/2016
