Provider Demographics
NPI:1558828459
Name:ONGJOCO, PERCIVAL TAMERLANE SANTIAGO
Entity Type:Individual
Prefix:
First Name:PERCIVAL TAMERLANE
Middle Name:SANTIAGO
Last Name:ONGJOCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 GEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3416
Mailing Address - Country:US
Mailing Address - Phone:415-833-1785
Mailing Address - Fax:415-833-5731
Practice Address - Street 1:2350 GEARY BLVD FL 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3305
Practice Address - Country:US
Practice Address - Phone:415-833-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10577227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered