Individual
MRS. GUAY KHIM FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN03201953
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-6120
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-6120
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
288457
CA
163WA2000X
Administrator Registered Nurse
Primary
288457
CA
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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