Individual
MATILDA BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11111 IRIS CT, CORONA, CA 92883-3112
(918) 949-1962
Mailing address
11111 IRIS CT, CORONA, CA 92883-3112
(918) 949-1962
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
95156829
CA
Other
Enumeration date
06/22/2022
Last updated
02/10/2023
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