Organization
INNOVATIVE NEUROLOGY, INC.
Active
Organization
INNOVATIVE NEUROLOGY, INC.
Active
Other names
Innovative Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE RAQUEL FUENTES MD (AUTHORIZED OFFICIAL)
(619) 306-1127
Entity
Organization
Contact information
Practice address
24671 MONROE AVE # C102, MURRIETA, CA 92562-9589
(951) 797-4446
(833) 989-2495
Mailing address
24671 MONROE AVE # C102, MURRIETA, CA 92562-9589
(951) 797-4446
(833) 989-2495
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
02/15/2021
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