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Individual

DONALD VIDANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RCP, RRT, NPS

Contact information

Practice address
6170 WINTERBERRY PL, RANCHO CUCAMONGA, CA 91739-9098
(951) 897-7972
Mailing address
6170 WINTERBERRY PL, RANCHO CUCAMONGA, CA 91739-9098
(951) 897-7972

Taxonomy

Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
13993
CA
227900000X
Registered Respiratory Therapist
Primary
40763
CA
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
CA

Other

Enumeration date
04/26/2012
Last updated
04/26/2012
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