Healthcare Provider Details

I. General information

NPI: 1003918459
Provider Name (Legal Business Name): CONSTANTE U ABAYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N VENTURA RD # C
OXNARD CA
93030
US

IV. Provider business mailing address

1200 N VENTURA RD # C
OXNARD CA
93030
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-0730
  • Fax: 805-485-4586
Mailing address:
  • Phone: 805-983-0730
  • Fax: 805-485-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA24454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: