Provider Demographics
NPI:1851098974
Name:TANTOCO, RIZA (RDH)
Entity Type:Individual
Prefix:
First Name:RIZA
Middle Name:
Last Name:TANTOCO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5013 S CENTENNIAL CIR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-7207
Mailing Address - Country:US
Mailing Address - Phone:714-696-8415
Mailing Address - Fax:
Practice Address - Street 1:5013 S CENTENNIAL CIR
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-7207
Practice Address - Country:US
Practice Address - Phone:714-696-8415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist