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Individual

JACOB ALEXANDRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7761 VALLE VISTA DR, RANCHO CUCAMONGA, CA 91730-1837
(407) 580-0406
Mailing address
7761 VALLE VISTA DR, RANCHO CUCAMONGA, CA 91730-1837
(407) 580-0406

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95074734
CA

Other

Enumeration date
08/11/2022
Last updated
08/11/2022
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