1902960123 NPI number — DR. ELIZABETH BABASA EBILANE MD

Table of content: DR. ELIZABETH BABASA EBILANE MD (NPI 1902960123)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902960123 NPI number — DR. ELIZABETH BABASA EBILANE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EBILANE
Provider First Name:
ELIZABETH
Provider Middle Name:
BABASA
Provider Name Prefix Text:
DR.
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:
1902960123
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 186
Provider Second Line Business Mailing Address:
SUBIC BAY FREEPORT ZONE
Provider Business Mailing Address City Name:
OLONGAPO CITY
Provider Business Mailing Address State Name:
ZAMBALES
Provider Business Mailing Address Postal Code:
2000
Provider Business Mailing Address Country Code:
PH
Provider Business Mailing Address Telephone Number:
63472237664
Provider Business Mailing Address Fax Number:
63472325245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
430 NATIONAL HI WAY
Provider Second Line Business Practice Location Address:
BO BARRETTO
Provider Business Practice Location Address City Name:
OLONGAPO CITY
Provider Business Practice Location Address State Name:
ZAMBALES
Provider Business Practice Location Address Postal Code:
2200
Provider Business Practice Location Address Country Code:
PH
Provider Business Practice Location Address Telephone Number:
63472237664
Provider Business Practice Location Address Fax Number:
63472325245
Provider Enumeration Date:
12/21/2006

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: 207Q00000X , with the licence number:  68080 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PHL002415 . This is a "TRICARE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: PHL009321 . This is a "TRICARE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com