Healthcare Provider Details

I. General information

NPI: 1699744524
Provider Name (Legal Business Name): MARIA SUSAN AFABLE BUHAY-MAGLUNOG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 S SUNSET AVE SUITE 201
WEST COVINA CA
91790-3961
US

IV. Provider business mailing address

1250 S SUNSET AVE SUITE 201
WEST COVINA CA
91790-3961
US

V. Phone/Fax

Practice location:
  • Phone: 626-962-3254
  • Fax: 626-962-1266
Mailing address:
  • Phone: 626-962-3254
  • Fax: 626-962-1266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA42390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: