Individual provider Active NPI

Milie Marie Tolentino, MD

  • Family Medicine Physician
  • Fullerton, CA
National Provider Identifier
1063531531
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A97078 Issued in CA
Practice address
731 S Highland Ave
Fullerton, CA 92832-2753
Phone
(714) 446-5100
Fax
(714) 449-1743
NPI assigned
Mar 28, 2007
Last updated
Oct 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A97078 CA Primary

Addresses

Primary practice location

731 S Highland Ave
Fullerton, CA 92832-2753

Mailing address

731 S Highland Ave
Fullerton, CA 92832-2753
Phone (714) 446-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A97078CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bakersfield Memorial Hospital Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mtolentino1374251@oc.providencedirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1063531531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S HIGHLAND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322753",
            "telephone_number": "714-446-5100",
            "fax_number": "714-449-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S HIGHLAND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322753",
            "telephone_number": "714-446-5100",
            "fax_number": "714-449-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "MILIE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A97078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.