MEDICARE: CHRISTINE JOY BACHO PABALATE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95090819	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053907154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE JOY BACHO PABALATE

Provider Business Mailing Address
First Line	:	255 3RD AVE
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94014-2968
Country	:	US
Telephone Number	:	818-406-8196
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 22ND ST # W94
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2815
Country	:	US
Telephone Number	:	628-206-8524
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2020
Last Update Date	:	12/14/2020

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