Individual
ECSTACY PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 W. 17TH ST, SANTA ANA, CA 92706
(714) 954-0432
(714) 796-6265
Mailing address
1212 W. 17TH ST, SANTA ANA, CA 92706
(714) 954-0432
(714) 796-6265
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
51945
CA
Other
Enumeration date
10/06/2014
Last updated
03/13/2025
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