Healthcare Provider Details

I. General information

NPI: 1285614081
Provider Name (Legal Business Name): ANTONIO GUINTO BALINGIT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 12/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 REID STREET TACOMA, WA 98431
APO AE
98431
US

IV. Provider business mailing address

MADIGAN ARMY MEDICAL CENTER 9040 REID ST., ATTN: MCHJ-QCR
TACOMA WA
98431-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1645
  • Fax:
Mailing address:
  • Phone: 253-968-2252
  • Fax: 253-968-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number01039002A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: