Individual
COLLINS BOAMPONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10935 TERRA VISTA PKWY APT 244, RANCHO CUCAMONGA, CA 91730-6360
(909) 944-3205
Mailing address
1805 MEDICAL CENTER DR, SAN BERNARDINO, CA 92411-1217
(909) 887-6333
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP950000655
CA
Other
Enumeration date
05/19/2014
Last updated
10/19/2020
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