Provider Demographics
NPI:1821172065
Name:BAGINGITO, ALWIN WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:ALWIN
Middle Name:WILLIAM
Last Name:BAGINGITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41238 MARGARITA RD STE 104
Mailing Address - Street 2:
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 STE 104
Practice Address - Street 2:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG066628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
330809021OtherTAX ID NUMBER