Individual
LUIS CONCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
360 E 7TH ST STE D, UPLAND, CA 91786-6701
(909) 920-9193
Mailing address
612 W NEVADA ST, ONTARIO, CA 91762-4207
(909) 456-0189
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
95360417
CA
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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