Organization
BLUEMEDPLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AFOLARIN AYETIWA (CEO)
(909) 446-2329
Entity
Organization
Contact information
Practice address
10970 ARROW RTE STE 205, RANCHO CUCAMONGA, CA 91730-4839
(909) 446-2304
Mailing address
10970 ARROW RTE STE 205, RANCHO CUCAMONGA, CA 91730-4839
(909) 446-2304
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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