Individual
CORNELIUS CHARLES RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1405 SPRUCE ST STE A, RIVERSIDE, CA 92507-2410
(951) 715-5050
Mailing address
1405 SPRUCE ST STE A, RIVERSIDE, CA 92507-2410
(951) 715-5050
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/25/2019
Last updated
03/25/2019
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