Provider Demographics
NPI:1619579380
Name:ILORETA, BILLY JAMES TOLENTINO
Entity Type:Individual
Prefix:MR
First Name:BILLY JAMES
Middle Name:TOLENTINO
Last Name:ILORETA
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 1:5124 LOKENE ST
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-2068
Mailing Address - Country:US
Mailing Address - Phone:808-634-5822
Mailing Address - Fax:
Practice Address - Street 1:5124 LOKENE ST
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-2068
Practice Address - Country:US
Practice Address - Phone:808-634-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)