Individual
BOB IDRIS MUTEBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18245 MILLBROOK AVE, LATHROP, CA 95330-9234
(310) 985-2530
Mailing address
18245 MILLBROOK AVE, LATHROP, CA 95330-9234
(310) 985-2530
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
95045550
CA
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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