Provider Demographics
NPI:1770516312
Name:ABAYA, PATRIA UBAN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRIA
Middle Name:UBAN
Last Name:ABAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PATRIA
Other - Middle Name:ABAYA
Other - Last Name:NATIVIDAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:225 SPRUCE CORNER GRAND AVE.
Mailing Address - Street 2:2ND FLOOR GRAND SPRUCE MEDICAL/DENTAL BUILDING
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080
Mailing Address - Country:US
Mailing Address - Phone:650-588-1237
Mailing Address - Fax:650-588-2243
Practice Address - Street 1:#225 SPRUCE AVE. COR. GRAND AVE.
Practice Address - Street 2:2ND FLOOR GRAND SPRUCE MEDICAL/DENTAL BUILDING
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080
Practice Address - Country:US
Practice Address - Phone:650-588-1237
Practice Address - Fax:650-588-2243
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA227160207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA2271600OtherPROVIDER NO