1326590613 NPI number — DARREN DALISAY ARBIOL B.S.

Table of content: DARREN DALISAY ARBIOL B.S. (NPI 1326590613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326590613 NPI number — DARREN DALISAY ARBIOL B.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARBIOL
Provider First Name:
DARREN
Provider Middle Name:
DALISAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
B.S.
Provider Gender Code:
M

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:
1326590613
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2761 GUMDROP DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95148-2023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-533-3069
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 THE ALAMEDA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95126-1136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-261-7777
Provider Business Practice Location Address Fax Number:
408-259-2273
Provider Enumeration Date:
11/02/2016

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: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9961921D46263 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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