Provider Demographics
NPI:1942810049
Name:MALINTANG, ANDREW CHRISTIAN
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CHRISTIAN
Last Name:MALINTANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1466 SHANE CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-5710
Mailing Address - Country:US
Mailing Address - Phone:909-583-7283
Mailing Address - Fax:
Practice Address - Street 1:1466 SHANE CT
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-5710
Practice Address - Country:US
Practice Address - Phone:909-583-7283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031923163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty