Basic Information
| Provider Information | |||||||||
| NPI: | 1942327820 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINTADO | ||||||||
| FirstName: | EMMA | ||||||||
| MiddleName: | OLIVIA | ||||||||
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| Credential: | LVN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 442 CRESTGLEN RD | ||||||||
| Address2: | |||||||||
| City: | GLENDORA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917412169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264370171 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18612 SANTA ANA AVE | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923162636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094217120 | ||||||||
| FaxNumber: | 9094217128 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2007 | ||||||||
| LastUpdateDate: | 02/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | VN196410 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.