Individual
DEL GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1850 S WATERMAN AVE, SUITE F, SAN BERNARDINO, CA 92408-2877
(909) 890-9393
Mailing address
1850 S WATERMAN AVE, SUITE F, SAN BERNARDINO, CA 92408-2877
(909) 890-9393
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN348835
CA
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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