Individual
JONATHAN ALLEN SAN LUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8710 MONROE CT STE 200, RANCHO CUCAMONGA, CA 91730-4884
(909) 481-9515
(909) 481-9520
Mailing address
8710 MONROE CT STE 200, RANCHO CUCAMONGA, CA 91730-4884
(909) 481-9515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95028524
CA
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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