Individual
ERIKA IVETH BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1344 N PAMPAS AVE, RIALTO, CA 92376-3647
(909) 440-7720
Mailing address
1344 N PAMPAS AVE, RIALTO, CA 92376-3647
(323) 749-0190
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B8815292
CA
Other
Enumeration date
12/20/2022
Last updated
03/17/2023
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