Individual
MEGA MANINDER DEOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-6809
(909) 825-7084
Mailing address
19069 VAN BUREN BLVD # 114-464, RIVERSIDE, CA 92508-9169
(951) 757-0664
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95014127
CA
Other
Enumeration date
03/11/2020
Last updated
03/07/2022
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