Individual
RONALD D FILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNFA
Contact information
Practice address
2776 PACIFIC AVE, PACIFIC HOSPITAL OF LONG BEACH, LONG BEACH, CA 90806-2613
(760) 534-9550
(951) 808-9700
Mailing address
PO BOX 6580, LONG BEACH, CA 90806-6580
(760) 534-9550
(951) 808-9700
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
305990
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305990
CRNFA LIC NUMBER
CA
Enumeration date
06/06/2007
Last updated
07/08/2007
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