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Individual

MR. OPAL DY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
7342 QUINCY PL, RANCHO CUCAMONGA, CA 91730-8293
(909) 210-2439
Mailing address
7342 QUINCY PL, RANCHO CUCAMONGA, CA 91730-8293

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
506924
CA

Other

Enumeration date
06/08/2021
Last updated
06/08/2021
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