Basic Information
Provider Information
NPI: 1346391380
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAGBUHOS
FirstName: CELERINO
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE MEDICARE ENROLLMENT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 6501 LOISDALE CT
Address2: KAISER PERMANENTE SPRINGFIELD MEDICAL CENTER
City: SPRINGFIELD
State: VA
PostalCode: 221501826
CountryCode: US
TelephoneNumber: 7039221000
FaxNumber: 7039221111
Other Information
ProviderEnumerationDate: 01/16/2007
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101045141VAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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