Provider Demographics
NPI:1912177759
Name:ALILING, JOSE-NITRAM PANGILINAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE-NITRAM
Middle Name:PANGILINAN
Last Name:ALILING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5767 W CENTURY BLVD SUITE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-5631
Mailing Address - Country:US
Mailing Address - Phone:310-301-8707
Mailing Address - Fax:
Practice Address - Street 1:100 MOODY CT STE 200
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6082
Practice Address - Country:US
Practice Address - Phone:805-418-3500
Practice Address - Fax:215-456-3898
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA101748207R00000X, 207R00000X
IL125.080536207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A1017480OtherBLUE SHIELD OF CALIFORNIA
PAMT205507Medicare PIN
CAAV601ZMedicare PIN