| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Forest Searls Tennant, Jr. | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Forest | [sources] | |||
| Last name | Tennant, Jr. | [sources] | |||
| Middle name | Searls | [sources] | |||
| NPI | 1720278252 | [sources] | |||
| Registration number | 00G221410 · 00G221411 · 00G221412 · 00G221413 · 00G221414 · | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 1744 Aspen Village Way, West Covina, CA, 91791 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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