Provider Demographics
NPI:1356335731
Name:ALB, OVIDIU (MD)
Entity type:Individual
Prefix:DR
First Name:OVIDIU
Middle Name:
Last Name:ALB
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 1:480 4TH AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4412
Mailing Address - Country:US
Mailing Address - Phone:619-427-3361
Mailing Address - Fax:619-427-6821
Practice Address - Street 1:480 4TH AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4412
Practice Address - Country:US
Practice Address - Phone:619-427-3361
Practice Address - Fax:619-427-6821
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1356335731Medicare UPIN