Individual
MR. RONALD MAR TENORIO ATILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AG-ACNP-BC
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
611 PARADISE WAY, NATIONAL CITY, CA 91950-3060
(747) 257-9053
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
95008863
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
95008863
CA
363LG0600X
Gerontology Nurse Practitioner
95008863
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000070078
AMERICAN ASSOCIATION OF CRITICAL CARE NURSES
CA
01
—
768953
BOARD OF NURSING
CA
01
—
95008863
CALIFORNIA BOARD OF NURSING
CA
Enumeration date
04/06/2018
Last updated
05/31/2022
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