1861674376 NPI number — A. RAY MABAQUIAO M.D. APMC

Table of content: (NPI 1861674376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861674376 NPI number — A. RAY MABAQUIAO M.D. APMC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A. RAY MABAQUIAO M.D. APMC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1861674376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8851 CENTER DR
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
LA MESA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91942-3017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-353-0488
Provider Business Mailing Address Fax Number:
760-353-2796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1745 S IMPERIAL AVE STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL CENTRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92243-4252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-353-0488
Provider Business Practice Location Address Fax Number:
760-353-2796
Provider Enumeration Date:
11/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MABAQUIAO
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
619-644-0488

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , 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)