Individual
MR. EAN KENNETH LLANDA TOLENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3130 WILSHIRE BLVD STE 409, LOS ANGELES, CA 90010-1206
(213) 389-1004
(213) 263-2131
Mailing address
2016 TUPELO WAY, ANTIOCH, CA 94509-9366
(925) 759-2544
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
CA
Enumeration date
09/19/2020
Last updated
09/19/2020
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