Organization
AMAZING RAINBOW INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FUKUDA MD (MEDICAL DIRECTOR)
(909) 528-6858
Entity
Organization
Contact information
Practice address
721 NEVADA ST, 404, REDLANDS, CA 92373-8079
(909) 528-6858
(909) 798-9999
Mailing address
721 NEVADA ST, 404, REDLANDS, CA 92373-8079
(909) 528-6858
(909) 798-9999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP13242
CA
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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