Individual
AGNES B KINTANAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1292 W MILL ST, SUITE 105, SAN BERNARDINO, CA 92410-2500
(909) 383-9440
(909) 383-9443
Mailing address
1292 W MILL ST, SUITE 105, SAN BERNARDINO, CA 92410-2500
(909) 383-9440
(909) 383-9443
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A38376
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A383760
—
CA
05
—
00A383761
—
CA
Enumeration date
07/19/2007
Last updated
11/17/2016
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