Individual
BLANCA ESTELA MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
671 E COOLEY DR STE 102, COLTON, CA 92324-4014
(909) 261-0483
Mailing address
1661 DAVIDSON ST, LOMA LINDA, CA 92354-1708
(909) 261-0483
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SLD5882
CA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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