1588627137 NPI number — MRS. ADA G PAISAN GALBAN MD

Table of content: MRS. ADA G PAISAN GALBAN MD (NPI 1588627137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588627137 NPI number — MRS. ADA G PAISAN GALBAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAISAN GALBAN
Provider First Name:
ADA
Provider Middle Name:
G
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1588627137
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 362352
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936-2352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-752-6505
Provider Business Mailing Address Fax Number:
787-752-6505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE MONSERRATE BH 12
Provider Second Line Business Practice Location Address:
VALLE ARRIBA HEIGHTS
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00983
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-752-6505
Provider Business Practice Location Address Fax Number:
787-752-6505
Provider Enumeration Date:
04/06/2006

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: 208D00000X , with the licence number:  14387 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 897015382 . This is a "MAPFRE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9492 . This is a "INTERNATIONAL MEDICAL CAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500253E . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100470 . This is a "CRUZ AZUL DE PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3493 . This is a "AMERICAN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21075PA . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9830022 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: PG4408 . This is a "PAN AMERICAN LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11914387MG . This is a "GLOBAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201345 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".




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