Individual
DIVINA C LURES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14566 ROCHESTER AVE, CHINO, CA 91710-6970
(909) 455-2433
Mailing address
14566 ROCHESTER AVE, CHINO, CA 91710-6970
(909) 455-2433
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
265624
CA
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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