Provider Demographics
NPI:1366802654
Name:PAGTULINGAN, LILA (COTA)
Entity type:Individual
Prefix:MRS
First Name:LILA
Middle Name:
Last Name:PAGTULINGAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1056 NIOLO ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5117
Mailing Address - Country:US
Mailing Address - Phone:808-371-0431
Mailing Address - Fax:
Practice Address - Street 1:91-1056 NIOLO ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-5117
Practice Address - Country:US
Practice Address - Phone:808-371-0431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI31400000X314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility