Basic Information
| Provider Information | |||||||||
| NPI: | 1003806407 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PACIA-RANTAYO | ||||||||
| FirstName: | PRECIOSA | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 VREELAND DR | ||||||||
| Address2: | |||||||||
| City: | YORKTOWN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236923120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573147887 | ||||||||
| FaxNumber: | 7573147577 | ||||||||
| Practice Location | |||||||||
| Address1: | MCDONALD ARMY COMMUNITY HOSPITAL | ||||||||
| Address2: | |||||||||
| City: | FORT EUSTIS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573147887 | ||||||||
| FaxNumber: | 7573147511 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171000000X | 0101231477 | VA | Y | Other Service Providers | Military Health Care Provider |
No ID Information.