Provider Demographics
NPI:1467407403
Name:PALTING, ROSEMARIE BANAGA (PA-C)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:BANAGA
Last Name:PALTING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ROSEMARIE
Other - Middle Name:BANAGA
Other - Last Name:PALTING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCCPA
Mailing Address - Street 1:PO BOX 1431
Mailing Address - Street 2:
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535-0431
Mailing Address - Country:US
Mailing Address - Phone:707-423-2356
Mailing Address - Fax:707-423-7419
Practice Address - Street 1:101 BODIN CIR
Practice Address - Street 2:
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535-1809
Practice Address - Country:US
Practice Address - Phone:707-423-2356
Practice Address - Fax:707-042-3741
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant