Provider Demographics
NPI:1053357012
Name:OLEGARIO, ALBERTA CATAAG (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERTA
Middle Name:CATAAG
Last Name:OLEGARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N SECOND AVE
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311
Mailing Address - Country:US
Mailing Address - Phone:760-256-3568
Mailing Address - Fax:760-256-7470
Practice Address - Street 1:209 N SECOND AVE
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311
Practice Address - Country:US
Practice Address - Phone:760-256-3568
Practice Address - Fax:760-256-7470
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A382580Medicaid
A28578Medicare UPIN
CA00A382580Medicaid