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General NPI Number Information
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NPI Number | 1730355082
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Entity Type | Organization
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Legal Business Name | PABLITO A. TANCINCO,M.D.,P.C.
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 2105 BEVERLY BLVD SUITE #111
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City | LOS ANGELES
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State | CA
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Zip | 90057-2216
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Country | US
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Telephone | 213-413-2280
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Fax | 213-413-0327
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Provider Business Mailing Address
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Address Line | 2105 BEVERLY BLVD SUITE #111
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City | LOS ANGELES
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State | CA
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Zip | 90057-2216
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Country | US
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Telephone | 213-413-2280
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Fax | 213-413-0327
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PABLITO AGUILAR TANCINCO
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Credential | M.D.
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Telephone | 213-413-2280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C42661
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License Number State | CA
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