Individual
NISREIN ABDELLATIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
404 BETHELL AVE, MOUNTAIN HOUSE, CA 95391-1050
(209) 650-5506
Mailing address
404 BETHELL AVE, MOUNTAIN HOUSE, CA 95391-1050
(209) 650-5506
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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