Individual
RUNA CHISLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(951) 788-3000
Mailing address
4361 SUFFOLK ST, RIVERSIDE, CA 92509-7812
(720) 296-1767
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95183592
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001249
CA
Other
Enumeration date
09/06/2019
Last updated
02/07/2020
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