Provider Demographics
NPI:1033320353
Name:SAW, AQUILINA TOLENTINO (MD)
Entity Type:Individual
Prefix:DR
First Name:AQUILINA
Middle Name:TOLENTINO
Last Name:SAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AQUILINA
Other - Middle Name:TOLENTINO
Other - Last Name:SAW-DEJESUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1320 PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6205
Mailing Address - Country:US
Mailing Address - Phone:562-596-9798
Mailing Address - Fax:
Practice Address - Street 1:1320 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6205
Practice Address - Country:US
Practice Address - Phone:562-596-9798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA029606208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA8250Medicare UPIN