Provider Demographics
NPI:1649557646
Name:ASIS, CAESAR GERALD SIBBU (RN)
Entity Type:Individual
Prefix:
First Name:CAESAR GERALD
Middle Name:SIBBU
Last Name:ASIS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 W 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-3168
Mailing Address - Country:US
Mailing Address - Phone:907-317-8364
Mailing Address - Fax:
Practice Address - Street 1:2313 W 47TH AVE.
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-3168
Practice Address - Country:US
Practice Address - Phone:907-317-8364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA797463163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse