Provider Demographics
NPI:1336303536
Name:JOSELITO P. BABARAN, INC.
Entity Type:Organization
Organization Name:JOSELITO P. BABARAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSELITO
Authorized Official - Middle Name:PONCE
Authorized Official - Last Name:BABARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-342-4440
Mailing Address - Street 1:8340 VAN NUYS BLVD
Mailing Address - Street 2:UNIT L
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-3693
Mailing Address - Country:US
Mailing Address - Phone:818-822-5271
Mailing Address - Fax:818-342-4410
Practice Address - Street 1:8340 VAN NUYS BLVD
Practice Address - Street 2:UNIT L
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-3693
Practice Address - Country:US
Practice Address - Phone:818-822-5271
Practice Address - Fax:818-342-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51480261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF58671Medicare UPIN