Provider Demographics
NPI:1003918459
Name:ABAYA, CONSTANTE U (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANTE
Middle Name:U
Last Name:ABAYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N VENTURA RD
Mailing Address - Street 2:# C
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030
Mailing Address - Country:US
Mailing Address - Phone:805-983-0730
Mailing Address - Fax:805-485-4586
Practice Address - Street 1:1200 N VENTURA RD
Practice Address - Street 2:# C
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030
Practice Address - Country:US
Practice Address - Phone:805-983-0730
Practice Address - Fax:805-485-4586
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24454207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A244540Medicaid
CAA24454Medicare ID - Type Unspecified
A23988Medicare UPIN