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General NPI Number Information
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NPI Number | 1033751938
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Entity Type | Individual
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Provider Name | RAYMOND BALAGTAS TINIO NP
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Gender | Male
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 829 N LA CADENA DR
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City | COLTON
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State | CA
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Zip | 92324-2747
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Country | US
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Telephone | 562-310-5772
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Fax | 818-752-9911
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Provider Business Mailing Address
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Address Line | 829 N LA CADENA DR
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City | COLTON
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State | CA
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Zip | 92324-2747
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Country | US
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Telephone | 818-853-2817
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Fax | 818-752-9911
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95011350
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License Number State | CA
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