Healthcare Provider Details

I. General information

NPI: 1518135573
Provider Name (Legal Business Name): NAVSTA PRIMARY CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3116 3RD FLOOR FESTIVAL SUPERMALL FILINVEST CORP. CITY
ALABANG MUNTINLUPA MANILA
1740
PH

IV. Provider business mailing address

3116 3RD FLOOR FESTIVAL SUPERMALL FILINVEST CORP.CITY
ALABANG MUNTINLUPA MANILA
1740
PH

V. Phone/Fax

Practice location:
  • Phone: 632-809-2736
  • Fax: 632-809-2736
Mailing address:
  • Phone: 632-809-2736
  • Fax: 632-809-2736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. IRENE SIMON CORTEZ
Title or Position: CLINIC MANAGER
Credential:
Phone: 632-809-2736