Individual
ASILI MAISHA WILBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
831 E ARROW HWY, POMONA, CA 91767-2535
(909) 398-4383
(909) 398-0127
Mailing address
3612 N D ST, SAN BERNARDINO, CA 92405-2106
(909) 804-2702
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
212323
CA
Other
Enumeration date
02/28/2008
Last updated
02/21/2017
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