Individual
MARIO KHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1900 CLEMENTINE ST, REDLANDS, CA 92374-1615
(714) 589-4507
Mailing address
1900 CLEMENTINE ST, REDLANDS, CA 92374-1615
(714) 589-4507
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95076500
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002186
CA
Other
Enumeration date
07/31/2023
Last updated
12/13/2023
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