Provider Demographics
NPI:1962684282
Name:TOLENTINO, ARTHUR R
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:R
Last Name:TOLENTINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ARTHUR
Other - Middle Name:R
Other - Last Name:TOLENTINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:315 MERCY AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8363
Mailing Address - Country:US
Mailing Address - Phone:209-564-3120
Mailing Address - Fax:209-564-3138
Practice Address - Street 1:315 MERCY AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340
Practice Address - Country:US
Practice Address - Phone:209-564-3120
Practice Address - Fax:209-564-3138
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52281207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF26886OtherBS
DC5372OtherBC/BS