MEDICARE: DR. RUBY DEGUZMAN MANALASTAS M.D.

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	2084P0800X	Psychiatry Physician	M001423	GU

General Provider Information

NPI Number	:	1760604185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUBY DEGUZMAN MANALASTAS M.D.

Provider Business Mailing Address
First Line	:	908 G. ARANETA AVENUE
Second Line	:
City	:	QUEZON CITY
State	:	METRO MANILA
Zip	:	1100
Country	:	PH
Telephone Number	:	632-416-2451
Fax Number	:	632-711-4429

Provider Business Practice Location Address
First Line	:	DEPARTMENT OF MENTAL HEALTH
Second Line	:	790 GOV. CAMACHO ROAD
City	:	TAMUNING
State	:	GU
Zip	:	96911
Country	:	US
Telephone Number	:	671-647-5354
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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