Provider Demographics
NPI:1972513695
Name:ITURBE, IGNACIO (MD)
Entity type:Individual
Prefix:
First Name:IGNACIO
Middle Name:
Last Name:ITURBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 3RD AVE STE 3330
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-1350
Mailing Address - Country:US
Mailing Address - Phone:619-745-1031
Mailing Address - Fax:619-745-1032
Practice Address - Street 1:855 3RD AVE STE 3330
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1350
Practice Address - Country:US
Practice Address - Phone:619-745-1031
Practice Address - Fax:619-745-1032
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42415207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA42415GOtherMEDICARE PTAN
CAB50490Medicare UPIN