Healthcare Provider Details

I. General information

NPI: 1861674376
Provider Name (Legal Business Name): A. RAY MABAQUIAO M.D. APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 S IMPERIAL AVE STE C
EL CENTRO CA
92243-4252
US

IV. Provider business mailing address

8851 CENTER DR SUITE 310
LA MESA CA
91942-3017
US

V. Phone/Fax

Practice location:
  • Phone: 760-353-0488
  • Fax: 760-353-2796
Mailing address:
  • Phone: 760-353-0488
  • Fax: 760-353-2796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. ARTHUR RAY MABAQUIAO
Title or Position: OWNER
Credential: MD
Phone: 619-644-0488