Healthcare Provider Details

I. General information

NPI: 1033318191
Provider Name (Legal Business Name): RHODORA PADILLA TOLENTINO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RHODORA TOLENTINO GONZALES M.D.

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20151 NORDHOFF ST
CHATSWORTH CA
91311-6215
US

IV. Provider business mailing address

20151 NORDHOFF ST
CHATSWORTH CA
91311-6215
US

V. Phone/Fax

Practice location:
  • Phone: 818-407-3200
  • Fax: 818-775-4552
Mailing address:
  • Phone: 818-407-3200
  • Fax: 818-775-4552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA 101194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: