Individual
JOHN DAVID LII
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3398 UTAH ST, RIVERSIDE, CA 92507
(951) 824-0376
Mailing address
3398 UTAH ST, RIVERSIDE, CA 92507-3962
(951) 824-0376
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A128189
CA
Other
Enumeration date
05/08/2012
Last updated
06/06/2018
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