Provider Demographics
NPI:1962534768
Name:PEREIRA NARVAEZ, DYLIA ODETTE (MD)
Entity type:Individual
Prefix:DR
First Name:DYLIA
Middle Name:ODETTE
Last Name:PEREIRA NARVAEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DYLIA
Other - Middle Name:ODETTE
Other - Last Name:DA REITZ PEREIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:77 W MARCH LN
Mailing Address - Street 2:STE A
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5724
Mailing Address - Country:US
Mailing Address - Phone:209-477-5552
Mailing Address - Fax:209-477-5552
Practice Address - Street 1:14114 BUSINESS CENTER DR
Practice Address - Street 2:SUITE E
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-9113
Practice Address - Country:US
Practice Address - Phone:951-656-3303
Practice Address - Fax:951-656-3375
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine