Milagros Tolentino, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A31830 Issued in CA

Practice address

15666 18TH Ave
Clearlake, CA 95422

Phone

(707) 994-9469

Fax

(707) 994-8758

NPI assigned

Nov 14, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1245212505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1350",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954221350",
            "telephone_number": "707-994-9469",
            "fax_number": "707-994-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15666 18TH AVE",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "95422",
            "telephone_number": "707-994-9469",
            "fax_number": "707-994-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "MILAGROS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A31830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CALIFORNIA",
            "identifier": "A31830",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00A318300",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A318300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayme Thomas
• Alexis Thompson, PA-C
• Janet Lynn Thomson, RRW- 0106
• Thrifty Payless Inc (Rite Aid Pharmacy 06026)
• Jay El Tillman
• Summer Maree Trongo
• Elsa M Valdivia, MD
• Krista Ann Van Vranken, BA MPA
• Kimberland Dale Vanhorn, RASI
• Rebecca Inez Vasquez, PEER SUPPORT SPC

• Internal Medicine Physician in Clearlake, CA
• Providers in Clearlake, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.