Provider Demographics
NPI:1043215502
Name:TIU, ALFREDO B (DO)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:B
Last Name:TIU
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:OWEN CLINIC
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9001
Mailing Address - Country:US
Mailing Address - Phone:619-543-2415
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:OWEN CLINIC
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9001
Practice Address - Country:US
Practice Address - Phone:619-543-2415
Practice Address - Fax:619-543-2415
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2007-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7678207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH23300Medicare UPIN