Individual
EGBERT TANTIONGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCH TECH, RN
Contact information
Practice address
1460 E WILLOW ST, SIGNAL HILL, CA 90755-3549
(310) 938-3215
Mailing address
1460 E WILLOW ST, SIGNAL HILL, CA 90755-3549
(310) 938-3215
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40362
CA
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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