Individual
IKE BANTILAN LARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 EDMONDS RD., BUILDING D, REDWOOD CITY, CA 94062
(650) 209-1100
Mailing address
240 EDMONDS RD., BUILDING D, REDWOOD CITY, CA 94062
(650) 209-1100
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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