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Organization
WELLFLEET FAMILY MEDICAL INC A MEDICAL CORPORATION
Active
Organization
WELLFLEET FAMILY MEDICAL INC A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE M HOLLENBECK FNP (PRESIDENT)
(909) 938-2681
Entity
Organization
Contact information
Practice address
600 N MOUNTAIN AVE, SUITE A-100, UPLAND, CA 91786-4359
(909) 938-2681
Mailing address
600 N MOUNTAIN AVE, SUITE A-100, UPLAND, CA 91786-4359
(909) 938-2681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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