1528083219 NPI number — DR. NANETTE MILLAN MACASINAG M.D.

Table of content: DR. NANETTE MILLAN MACASINAG M.D. (NPI 1528083219)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528083219 NPI number — DR. NANETTE MILLAN MACASINAG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACASINAG
Provider First Name:
NANETTE
Provider Middle Name:
MILLAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

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 Information

NPI Number:
1528083219
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1615 BUNKER HILL WAY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93906-6013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-796-1304
Provider Business Mailing Address Fax Number:
831-757-0291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1441 CONSTITUTION BLVD
Provider Second Line Business Practice Location Address:
BLDG. 200, FLOOR ONE, SUITE 101
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93906-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-755-4124
Provider Business Practice Location Address Fax Number:
831-759-6595
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  A39731 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ZZZ02040Z . This is a "MEDICARE GROUP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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