Individual
DR. ELPIDIO C MARIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
106 LYNCH CREEK WAY, SUITE 9B, PETALUMA, CA 94954-2356
(707) 763-1575
(707) 763-9172
Mailing address
106 LYNCH CREEK WAY, SUITE 9B, PETALUMA, CA 94954-2356
(707) 763-1575
(707) 763-9172
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A39817
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A398170
—
CA
Enumeration date
08/31/2006
Last updated
09/14/2010
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