=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427663871
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRESENDO AMOR HILARIO CATINDIG
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2020
-----------------------------------------------------
Last Update Date | 09/12/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1040 EL CAMINO REAL APT 205
-----------------------------------------------------
City | BURLINGAME
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94010-4978
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-303-7798
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1040 EL CAMINO REAL APT 205
-----------------------------------------------------
City | BURLINGAME
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94010-4978
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-303-7798
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 80900
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------