Provider Demographics
NPI:1699512723
Name:CABACUNGAN, ARGIE
Entity type:Individual
Prefix:
First Name:ARGIE
Middle Name:
Last Name:CABACUNGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 SILVER CREEK VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1059
Mailing Address - Country:US
Mailing Address - Phone:408-574-9156
Mailing Address - Fax:
Practice Address - Street 1:5855 SILVER CREEK VALLEY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1059
Practice Address - Country:US
Practice Address - Phone:408-574-9156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95214680163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory CareGroup - Single Specialty