Healthcare Provider Details

I. General information

NPI: 1942114202
Provider Name (Legal Business Name): JOHN ERIC O TOLENTINO CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E WASHINGTON BLVD
CRESCENT CITY CA
95531-8359
US

IV. Provider business mailing address

PO BOX 688
CRESCENT CITY CA
95531-0688
US

V. Phone/Fax

Practice location:
  • Phone: 707-464-8511
  • Fax:
Mailing address:
  • Phone: 210-748-8803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number13973
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: