Individual
JUAN FIDEL PENALOZA PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 CALIFORNIA DR, VACAVILLE, CA 95687
(707) 448-6841
Mailing address
1600 CALIFORNIA DR, VACAVILLE, CA 95687
(707) 448-6841
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A178289
CA
208M00000X
Hospitalist Physician
Primary
A178289
CA
261QP2400X
Prison Health Clinic/Center
Primary
A178289
CA
390200000X
Student in an Organized Health Care Education/Training Program
A178289
CA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/25/2020
Last updated
04/01/2026
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