Individual
AMANDA INGALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1310 SAN BERNARDINO RD, SUITE 101, UPLAND, CA 91786-4979
(909) 579-0779
(909) 579-0789
Mailing address
1310 SAN BERNARDINO RD, SUITE 101, UPLAND, CA 91786-4979
(909) 579-0779
(909) 579-0789
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
51923
CA
Other
Enumeration date
09/30/2014
Last updated
02/24/2015
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