Individual
BEN ARNOLD ADOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
12021 JACARANDA AVE STE 101, HESPERIA, CA 92345-4978
(760) 956-5057
(760) 947-2057
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3145
(909) 580-2165
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95042846
CA
207Q00000X
Family Medicine Physician
95021179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417473034
FAMILY PRACTICE
CA
Enumeration date
08/15/2017
Last updated
08/09/2023
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