# PROPHETE MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Liautaud Morin Prophete
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568658086
- **Authorized official:** DR. LIAUTAUD MORIN PROPHETE SR. D.O. (PRESIDENT)
- **Authorized official phone:** (209) 826-4771

## Contact information

- **Practice address:** 502 WASHINGTON AVE, LOS BANOS, CA 93635-4649
- **Practice address phone:** (209) 826-4771
- **Practice address fax:** (209) 826-8565
- **Mailing address:** PO BOX 2236, LOS BANOS, CA 93635-2236
- **Mailing address phone:** (209) 826-4771
- **Mailing address fax:** (209) 826-8565

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 20A9842 | CA | Yes |

## Other

- **Enumeration date:** 09/18/2007
- **Last updated:** 03/25/2019