Provider Demographics
NPI:1518135573
Name:NAVSTA PRIMARY CARE CLINIC
Entity Type:Organization
Organization Name:NAVSTA PRIMARY CARE CLINIC
Other - Org Name:NAVSTA PRIMARY CARE CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:632-809-2736
Mailing Address - Street 1:3116 3RD FLOOR FESTIVAL SUPERMALL
Mailing Address - Street 2:FILINVEST CORP.CITY
Mailing Address - City:ALABANG MUNTINLUPA
Mailing Address - State:MANILA
Mailing Address - Zip Code:1740
Mailing Address - Country:PH
Mailing Address - Phone:632-809-2736
Mailing Address - Fax:632-809-2736
Practice Address - Street 1:3116 3RD FLOOR FESTIVAL SUPERMALL
Practice Address - Street 2:FILINVEST CORP. CITY
Practice Address - City:ALABANG MUNTINLUPA
Practice Address - State:MANILA
Practice Address - Zip Code:1740
Practice Address - Country:PH
Practice Address - Phone:632-809-2736
Practice Address - Fax:632-809-2736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty