Mariano, Elpidio C
Mariano, Elpidio C is an sole proprietor health care provider with primary practice located at 106 Lynch Creek Way Suite 9B, Petaluma CA 94954-2356. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mariano, Elpidio C can be contacted via phone (707) 763-1575.Contact Information
Primary practice address
106 Lynch Creek Way Suite 9B
Petaluma CA 94954-2356
Phone: (707) 763-1575
Fax: (707) 763-9172
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | A39817 | California |
Profile Details
| NPI number | 1063524528 |
|---|---|
| LBN Legal business name | Mariano, Elpidio C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Sep 14th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063524528 | NPPES |
| California | MEDICAID | 00A398170 |
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