Provider Demographics
NPI:1508100769
Name:DISINI, ASUNCION PURISIMA (MD)
Entity type:Individual
Prefix:DR
First Name:ASUNCION
Middle Name:PURISIMA
Last Name:DISINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 WOODVIEW PL
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-3233
Mailing Address - Country:US
Mailing Address - Phone:408-268-8027
Mailing Address - Fax:
Practice Address - Street 1:1057 WOODVIEW PL
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-3233
Practice Address - Country:US
Practice Address - Phone:408-268-8027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-11
Last Update Date:2012-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39875208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD61827OtherMEDI-CAL UPIN