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Individual

RANELL ELMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1200 S CENTRAL AVE, GLENDALE, CA 91204-2504
(909) 522-0699
Mailing address
3351 INLAND EMPIRE BLVD, 17D, ONTARIO, CA 91764-4866
(909) 522-0699
(909) 980-8708

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
12/04/2006
Last updated
07/08/2007
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