Individual
ASUNCION SIBULO SUBIJANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
253 ACCOLADE DR, SAN LEANDRO, CA 94577-1587
(510) 461-4590
Mailing address
253 ACCOLADE DR, SAN LEANDRO, CA 94577-1587
(510) 461-4590
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
27516
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01138890
KAISER
CA
Enumeration date
05/07/2017
Last updated
05/07/2017
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