Doctor Name: | MAGDALENA ASUNCION BALTAZAR |
NPI Number: | 1114040433 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 94-904 Kuakahi St Waipahu, HI - 967972808 |
Business Phone Number: | 1808677496 |
Business Fax Number: | |
Mailing Address: | 94-904 Kuakahi St, WAIPAHU |
State: | HI |
Postal Code: | 967972808 |
Phone Number: | 1808677496 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |