Provider Demographics
NPI:1477528131
Name:PANGILINAN, ALICIA GARCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:GARCIA
Last Name:PANGILINAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 EDGEHILL CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6327
Mailing Address - Country:US
Mailing Address - Phone:757-426-2813
Mailing Address - Fax:
Practice Address - Street 1:2001 EDGEHILL CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-6327
Practice Address - Country:US
Practice Address - Phone:757-426-2813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239163207RG0300X, 207R00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902714Medicaid
VA010230152Medicaid
VA3165729OtherUHC/MAMSI
NC02714OtherNC BC/BS
VA187739OtherANTHEM
VA571583OtherSENTARA
VA571583OtherSENTARA
VA3165729OtherUHC/MAMSI
VABP9544897OtherDEA#
VAP00278368Medicare UPIN