Provider Demographics
NPI:1912177759
Name:ALILING, JOSE-NITRAM PANGILINAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE-NITRAM
Middle Name:PANGILINAN
Last Name:ALILING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5501 OLD YORK RD
Mailing Address - Street 2:KORMAN BUILDING, SUITE 103
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3018
Mailing Address - Country:US
Mailing Address - Phone:215-456-7380
Mailing Address - Fax:215-456-3898
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:KORMAN BUILDING,SUITE 103
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-7380
Practice Address - Fax:215-456-3898
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT205507390200000X
CAA101748207R00000X
IL125.080536207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A1017480OtherBLUE SHIELD OF CALIFORNIA
PAMT205507Medicare PIN
CAAV601ZMedicare PIN