Individual
MRS. BRENITTA GILLIAM-UDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
351 N MOUNTAIN VIEW AVE, SAN BERNARDINO, CA 92415-1018
(714) 748-8955
Mailing address
25064 BARTON RD, LOMA LINDA, CA 92354-2830
(909) 569-3576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15518
CA
Other
Enumeration date
08/20/2008
Last updated
08/20/2008
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