Provider Demographics
NPI:1366739963
Name:PINTOR, JESUSITO A
Entity type:Individual
Prefix:
First Name:JESUSITO
Middle Name:A
Last Name:PINTOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 N EL DORADO ST
Mailing Address - Street 2:STE 10B
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-1323
Mailing Address - Country:US
Mailing Address - Phone:209-948-1566
Mailing Address - Fax:209-948-3002
Practice Address - Street 1:1045 N EL DORADO ST
Practice Address - Street 2:STE 10B
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-1323
Practice Address - Country:US
Practice Address - Phone:209-948-1566
Practice Address - Fax:209-948-3002
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB4734322343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)