Healthcare Provider Details

I. General information

NPI: 1316268691
Provider Name (Legal Business Name): AURA M OBANDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 ALBANY ST BOSTON HEALTH CARE FOR THE HOMELESS
BOSTON MA
02118-2524
US

IV. Provider business mailing address

780 ALBANY ST BOSTON HEALTH CARE FOR THE HOMELESS
BOSTON MA
02118-2524
US

V. Phone/Fax

Practice location:
  • Phone: 857-654-1000
  • Fax:
Mailing address:
  • Phone: 857-654-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number258895
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number258895
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: