Provider Demographics
NPI:1962485243
Name:KUIZON, JEANETTE PAZ (MD)
Entity type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:PAZ
Last Name:KUIZON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JEANETTE
Other - Middle Name:CUBE
Other - Last Name:PAZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:737 W CHILDS AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-6805
Mailing Address - Country:US
Mailing Address - Phone:209-383-1848
Mailing Address - Fax:209-384-3966
Practice Address - Street 1:797 W CHILDS AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-6805
Practice Address - Country:US
Practice Address - Phone:209-383-5871
Practice Address - Fax:209-383-1402
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A797850OtherBLUE SHIELD OF CA PIN
CA00A797850OtherBLUE SHIELD OF CA PIN
CA00A797850Medicare ID - Type Unspecified
CA00A797850OtherBLUE SHIELD OF CA PIN