# FELICIANO NAVALTA JR., M.D. A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1942485313
- **Authorized official:** DR. FELICIANO SISON NAVALTA JR. M.D. (PHYSICAN)
- **Authorized official phone:** (562) 633-1404

## Contact information

- **Practice address:** 16660 PARAMOUNT BLVD, SUITE 306, PARAMOUNT, CA 90723-5433
- **Practice address phone:** (562) 633-1404
- **Practice address fax:** (562) 633-3036
- **Mailing address:** 16660 PARAMOUNT BLVD, SUITE 306, PARAMOUNT, CA 90723-5433
- **Mailing address phone:** (562) 633-1404
- **Mailing address fax:** (562) 633-3036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A25135 | CA | Yes |

## Other

- **Enumeration date:** 01/04/2008
- **Last updated:** 03/24/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A251351 | — | CA |