Provider Demographics
NPI:1346435625
Name:TINIO, BIBIANE KIM (NP)
Entity Type:Individual
Prefix:MRS
First Name:BIBIANE
Middle Name:KIM
Last Name:TINIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:550 WASHINGTON ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2213
Mailing Address - Country:US
Mailing Address - Phone:619-260-7021
Mailing Address - Fax:619-260-7038
Practice Address - Street 1:550 WASHINGTON ST
Practice Address - Street 2:SUITE 601
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2213
Practice Address - Country:US
Practice Address - Phone:619-260-7021
Practice Address - Fax:619-260-7038
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF320073363LC1500X
CANPF18168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily