Individual provider Active NPI

Marleen Santos Coronel, M.D.

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1417100322
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51674 Issued in CA
Practice address
1275 E Spruce Ave
Ste 106
Fresno, CA 93720-3372
Phone
(559) 439-5757
Fax
(559) 248-9585
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A51674 CA Primary

Addresses

Primary practice location

1275 E Spruce Ave
Ste 106
Fresno, CA 93720-3372

Mailing address

1275 E Spruce Ave
Fresno, CA 93720-3372
Phone (559) 439-5757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180412001641 CA Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 5193850154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1417100322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203372",
            "telephone_number": "559-439-5757",
            "fax_number": "559-248-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 E SPRUCE AVE",
            "address_2": "STE 106",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203372",
            "telephone_number": "559-439-5757",
            "fax_number": "559-248-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONEL",
        "first_name": "MARLEEN",
        "middle_name": "SANTOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.