Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A69847 | CA |
Y | 111NI0900X | Internist | A69847 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | A69847 | CA |
NPI | 1114952264 |
---|---|
Provider Name | Peter Panes Balingit |
First Address | Sylmar, CA 91342-1437 |
Second Address | Sylmar, CA 91342-1437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 24/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A698470 | (05) | CA |
I44553 | (02) |