Provider Demographics
NPI:1417049099
Name:LIMBO, PABLO CARANDANG JR (MD)
Entity Type:Individual
Prefix:
First Name:PABLO
Middle Name:CARANDANG
Last Name:LIMBO
Suffix:JR
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 1:19036 COLIMA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748
Mailing Address - Country:US
Mailing Address - Phone:626-965-7272
Mailing Address - Fax:626-965-9479
Practice Address - Street 1:19036 COLIMA RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748
Practice Address - Country:US
Practice Address - Phone:626-965-7272
Practice Address - Fax:626-965-9479
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A382490Medicaid
CAW11905Medicare ID - Type Unspecified
CA00A382490Medicaid