Provider Information for 1750832937
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MACHELLE PARDUE
Sex: Female
NPI: 1750832937
Last Updated: 2024-05-03
Certification Date: 2024-05-01
Certification Date: 2024-05-01
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1750832937 | ||||||||||||
| Enumeration Date | 2016-10-21 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4082 VALETA ST UNIT 361 SAN DIEGO, CA 92110-5823 United States Phone: 619-609-4937 | Fax: | ||||||||||||
| Primary Practice Address | 1400 PARKMOOR AVE SUITE 115 SAN JOSE, CA 95126-3797 United States Phone: 408-971-9822 | Fax: | ||||||||||||
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