Basic Information
| Provider Information | |||||||||
| NPI: | 1689944639 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TABIGO ON | ||||||||
| FirstName: | ROY EUGENE | ||||||||
| MiddleName: | GARIBAY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 460 N MERCEY SPRINGS RD | ||||||||
| Address2: | UNIT C | ||||||||
| City: | LOS BANOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936357416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9174556483 | ||||||||
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| Practice Location | |||||||||
| Address1: | 311 W I ST | ||||||||
| Address2: | |||||||||
| City: | LOS BANOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936353479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2098262222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2012 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | A120169 | CA | N | Allopathic & Osteopathic Physicians | General Practice | 207R00000X | A120169 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.