Provider Demographics
NPI:1225131030
Name:TOLENTINO, ARMINDA (MD)
Entity Type:Individual
Prefix:
First Name:ARMINDA
Middle Name:
Last Name:TOLENTINO
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 1:591 MCCRAY ST
Mailing Address - Street 2:#231
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-2224
Mailing Address - Country:US
Mailing Address - Phone:831-636-7495
Mailing Address - Fax:831-636-7496
Practice Address - Street 1:591 MCCRAY ST
Practice Address - Street 2:#231
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-2224
Practice Address - Country:US
Practice Address - Phone:831-636-7495
Practice Address - Fax:831-636-7496
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A4543650Medicaid
CA00A543650Medicare ID - Type Unspecified
CAG17331Medicare UPIN