Individual
MAGNUS C IHEMEDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1809 W REDLANDS BLVD, REDLANDS, CA 92373-8054
(909) 435-9740
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3144
(909) 580-2165
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
779746
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95007019
CA
Other
Enumeration date
06/02/2016
Last updated
08/05/2022
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