Provider Demographics
NPI:1104953983
Name:ALBINDA, LIBERACION P (MD)
Entity type:Individual
Prefix:MISS
First Name:LIBERACION
Middle Name:P
Last Name:ALBINDA
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 1:8921 BARIUM ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89143-1371
Mailing Address - Country:US
Mailing Address - Phone:702-396-1815
Mailing Address - Fax:
Practice Address - Street 1:920 W CYPRESS RD
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-2115
Practice Address - Country:US
Practice Address - Phone:925-783-4305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31017207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26314Medicare UPIN
CA00A310170Medicare ID - Type Unspecified