Individual
DORY LLAMADO GOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 WESTERN AVE STE 103, SAN BERNARDINO, CA 92411-1352
(909) 802-9374
Mailing address
11882 SANDRA CT, LOMA LINDA, CA 92354-6759
(909) 802-4362
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95022234
CA
363LF0000X
Family Nurse Practitioner
95022234
CA
363LP2300X
Primary Care Nurse Practitioner
95022234
CA
Other
Enumeration date
04/11/2023
Last updated
04/22/2023
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