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NPI Code Detail

MEDICARE: MRS. PERLITA BANTOLA ONG

MEDICARE: MRS. PERLITA BANTOLA ONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational NurseVN91798CA

General Provider Information

NPI Number : 1740433986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PERLITA BANTOLA ONG
Provider Business Mailing Address
First Line : 450 BAUCHET ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90012-2907
Country : US
Telephone Number : 213-893-5392
Fax Number :
Provider Business Practice Location Address
First Line : 450 BAUCHET ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90012-2907
Country : US
Telephone Number : 213-893-5392
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2008
Last Update Date : 10/31/2008

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Directions to “ MRS. PERLITA BANTOLA ONG ” Practice Location

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