Provider Demographics
NPI:1720382443
Name:REMIGIO, AUGUSTO L III
Entity Type:Individual
Prefix:
First Name:AUGUSTO
Middle Name:L
Last Name:REMIGIO
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 ABORN RD APT 212
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1571
Mailing Address - Country:US
Mailing Address - Phone:925-216-3273
Mailing Address - Fax:
Practice Address - Street 1:2175 ABORN RD APT 212
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1571
Practice Address - Country:US
Practice Address - Phone:925-216-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)