Provider Demographics
NPI:1619112315
Name:ALWIN WILLIAM BAGINGITO MD INC
Entity Type:Organization
Organization Name:ALWIN WILLIAM BAGINGITO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/M.D. PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ALWIN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BAGINGITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-695-6787
Mailing Address - Street 1:41238 MARGARITA RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5552
Mailing Address - Country:US
Mailing Address - Phone:951-695-6787
Mailing Address - Fax:
Practice Address - Street 1:41238 MARGARITA RD
Practice Address - Street 2:SUITE 104
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5552
Practice Address - Country:US
Practice Address - Phone:951-695-6787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66628261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G666280Medicare PIN