Individual
AMISH MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26001 REDLANDS BLVD, REDLANDS, CA 92373-7762
(909) 825-7084
Mailing address
26001 REDLANDS BLVD, LOMA LINDA, CA 92373-7762
(909) 825-7084
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
251566
CA
Other
Enumeration date
02/07/2026
Last updated
02/07/2026
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