Provider Demographics
NPI:1568097103
Name:TOLENTINO, JEULIAN ACERO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JEULIAN
Middle Name:ACERO
Last Name:TOLENTINO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 N FIGUEROA ST APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2036
Mailing Address - Country:US
Mailing Address - Phone:323-286-9565
Mailing Address - Fax:
Practice Address - Street 1:1101 S MILLIKEN AVE STE C
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-8112
Practice Address - Country:US
Practice Address - Phone:909-390-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ390200000XOtherSOUTHERN ARIZONA VA HEALTHCARE SYSTEM