Provider Demographics
NPI:1649229766
Name:CANOS, HILDA JALIPA (MD)
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:JALIPA
Last Name:CANOS
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 1:2859 BOUDINOT AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2496
Mailing Address - Country:US
Mailing Address - Phone:513-251-8222
Mailing Address - Fax:513-251-8227
Practice Address - Street 1:2859 BOUDINOT AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-1606
Practice Address - Country:US
Practice Address - Phone:513-251-8222
Practice Address - Fax:513-251-8227
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-46682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0478424Medicaid
OH0478424Medicaid
OHH213920Medicare PIN