Individual
DR. CARMELITA CASISON NISPEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 COTTAGE AVE, SUITE 202, MANTECA, CA 95336-4935
(209) 239-1996
(209) 239-2876
Mailing address
200 COTTAGE AVE, SUITE 202, MANTECA, CA 95336-4935
(209) 239-1996
(209) 239-2876
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A51093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A510930
—
CA
Enumeration date
08/31/2006
Last updated
07/08/2007
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