Healthcare Provider Details

I. General information

NPI: 1053449975
Provider Name (Legal Business Name): MILA TOLENTINO FLORES CNS, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 WASHINGTON BLVD
WHITTIER CA
90602-1006
US

IV. Provider business mailing address

274 WEST ASH STREET
BREA CA
92821-5088
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-0811
  • Fax: 562-789-6481
Mailing address:
  • Phone: 714-672-9025
  • Fax: 562-789-6481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number242336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: