Individual
JERRYPER COLEGADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-8514
Mailing address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
16076
CA
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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