Individual
BENNETT AGUBATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5425 SIERRA VISTA AVE, RIVERSIDE, CA 92505-3113
(951) 299-7545
Mailing address
5425 SIERRA VISTA AVE, RIVERSIDE, CA 92505-3113
(951) 299-7545
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
Other
Enumeration date
09/19/2022
Last updated
02/15/2024
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