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DALE TIGLAO BALILO RN

Psychiatric/Mental Health >> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1649855404

Individual Registrant:
 DALE TIGLAO BALILO RN
Gender: M
Sole Proprietor

Location and contact information for practice:
6108 BLACKTHORNE AVE  LAKEWOOD, CA 90712-1118 US
Tel: 619-218-8681  Fax: --

Contact information for business:
6108 BLACKTHORNE AVE  LAKEWOOD, CA 90712-1118 US
Tel: 619-218-8681  Fax: --

Registration Information:
NPI: 1649855404
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163WP0808XNursing Service Providers
Registered Nurse
Psychiatric/Mental Health
CA95160322

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CALIFORNIA REAL ID/DRIVER'S LICENSED2928760CA01




HEALTH CARE JOBS CA - Page 1



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