Provider Demographics
NPI:1790957124
Name:PABLO C LIMBO MD INC
Entity Type:Organization
Organization Name:PABLO C LIMBO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:CARANDANG
Authorized Official - Last Name:LIMBO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:626-965-7272
Mailing Address - Street 1:19036 COLIMA RD
Mailing Address - Street 2:STE B
Mailing Address - City:ROWLAND HTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748
Mailing Address - Country:US
Mailing Address - Phone:626-965-7272
Mailing Address - Fax:626-965-9479
Practice Address - Street 1:19036 COLIMA RD
Practice Address - Street 2:STE B
Practice Address - City:ROWLAND HTS
Practice Address - State:CA
Practice Address - Zip Code:91748
Practice Address - Country:US
Practice Address - Phone:626-965-7272
Practice Address - Fax:626-965-9479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A382490Medicaid
CAE57134Medicare UPIN
CA00A382490Medicaid