Individual
MALIK HUMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(951) 715-5040
Mailing address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(951) 715-5040
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-ITLASJ
CA
Other
Enumeration date
06/14/2024
Last updated
10/28/2024
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