Individual
CORNELIO EMMANUEL BENGZON RUSTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1324 WILLOWSTONE CT, SAN JACINTO, CA 92582-4247
(951) 665-3264
Mailing address
1324 WILLOWSTONE CT, SAN JACINTO, CA 92582-4247
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN534950
CA
363LF0000X
Family Nurse Practitioner
Primary
NP95007135
CA
Other
Enumeration date
12/12/2017
Last updated
12/12/2017
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