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Individual

MR. BAN IAN POLE BITONG PALOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, BSN

Contact information

Practice address
405 W 5TH ST, SANTA ANA, CA 92701-4599
(714) 834-5974
Mailing address
18592 WOODWIND LN, ANAHEIM, CA 92807-1108
(510) 361-7526

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN95176566
CA

Other

Enumeration date
04/02/2021
Last updated
04/02/2021
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