Provider Demographics
NPI:1184603706
Name:AFILAKA, ABOABA A (MD)
Entity type:Individual
Prefix:
First Name:ABOABA
Middle Name:A
Last Name:AFILAKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1140 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-1257
Mailing Address - Country:US
Mailing Address - Phone:209-394-7913
Mailing Address - Fax:209-394-9093
Practice Address - Street 1:7970 LANDER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HILMAR
Practice Address - State:CA
Practice Address - Zip Code:95324-8350
Practice Address - Country:US
Practice Address - Phone:209-262-1819
Practice Address - Fax:209-262-1817
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA1314352083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH73679Medicare UPIN
NYH73679Medicare UPIN