1376655696 NPI number — TIINA LUIG M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376655696 NPI number — TIINA LUIG M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

LUIG

Provider First Name:

TIINA

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1376655696

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/15/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

406 SUNRISE AVE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ROSEVILLE

Provider Business Mailing Address State Name:

CA

Provider Business Mailing Address Postal Code:

95661-4106

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

916-536-2500

Provider Business Mailing Address Fax Number:

916-780-3904

Provider First Line Business Practice Location Address:

3160 FOLSOM BLVD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SACRAMENTO

Provider Business Practice Location Address State Name:

CA

Provider Business Practice Location Address Postal Code:

95816-5202

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

916-733-3333

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

08/31/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Q00000X , with the licence number:  A80545 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 7906500 . This is a "AETNA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 98224 . This is a "INTERPLAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 00A805450 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000810522515 . This is a "PHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 1723628 . This is a "GREAT WEST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 4643189 . This is a "CIGNA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 2135188 . This is a "FIRST HEALTH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 90136844 . This is a "PACIFICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: A80545 . This is a "BLUE CROSS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 2358902 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: MCMG273300 . This is a "WESTERN HEALTH ADVANTAGE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
• Identifier: 102611 . This is a "HEALTH NET" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".