Individual
CORAZON F GHANDEHARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
817 COFFEE RD, C3, MODESTO, CA 95355-4241
(209) 529-9603
(209) 529-6610
Mailing address
817 COFFEE RD, C3, MODESTO, CA 95355-4241
(209) 529-9603
(209) 529-6610
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
464795
CA
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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