Individual
ANTHONY CORONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-5000
Mailing address
PO BOX 630, WALNUT GROVE, CA 95690-0630
(559) 978-1006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61181
CA
Other
Enumeration date
06/02/2022
Last updated
12/09/2022
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