Provider Demographics
NPI:1417926437
Name:JUMIG, ELMER ALAGAO (MD)
Entity Type:Individual
Prefix:DR
First Name:ELMER
Middle Name:ALAGAO
Last Name:JUMIG
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 1:2324 SANTA RITA RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4152
Mailing Address - Country:US
Mailing Address - Phone:925-462-7700
Mailing Address - Fax:925-462-7712
Practice Address - Street 1:2324 SANTA RITA RD
Practice Address - Street 2:SUITE 12
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4152
Practice Address - Country:US
Practice Address - Phone:925-462-7700
Practice Address - Fax:925-462-7712
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77244208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A772440Medicaid