Organization
DIRECT PROVIDER OF HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN PANGANIBAN RN (CHIEF EXECUTIVE OFFICER)
(909) 483-8311
Entity
Organization
Contact information
Practice address
9320 BASE LINE RD STE B, RANCHO CUCAMONGA, CA 91701-5829
(909) 483-8311
(909) 483-8382
Mailing address
9320 BASE LINE RD STE B, RANCHO CUCAMONGA, CA 91701-5829
(909) 483-8311
(909) 483-8382
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CA
Other
Enumeration date
02/27/2009
Last updated
09/16/2025
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