Basic Information
| Provider Information | |||||||||
| NPI: | 1053449975 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLORES | ||||||||
| FirstName: | MILA | ||||||||
| MiddleName: | TOLENTINO | ||||||||
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| Credential: | CNS, NNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 274 WEST ASH STREET | ||||||||
| Address2: | |||||||||
| City: | BREA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928215088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146729025 | ||||||||
| FaxNumber: | 5627896481 | ||||||||
| Practice Location | |||||||||
| Address1: | 12401 WASHINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906021006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626980811 | ||||||||
| FaxNumber: | 5627896481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WN0002X | 242336 | CA | Y | Nursing Service Providers | Registered Nurse | Neonatal Intensive Care |
No ID Information.