Provider Demographics
NPI:1700132008
Name:BAGUILOD, CLAIRE AILEEN A
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE AILEEN
Middle Name:A
Last Name:BAGUILOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7282 BIRCH CIR
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-4504
Mailing Address - Country:US
Mailing Address - Phone:904-651-7568
Mailing Address - Fax:
Practice Address - Street 1:7282 BIRCH CIR
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-4504
Practice Address - Country:US
Practice Address - Phone:904-651-7568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT3535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist