Individual
MRS. GHAZALA MALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00441235
CA
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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