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Individual

DR. AMANDA LEEANN ETHERIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354
(618) 599-9904
Mailing address
1498 BROOKSIDE AVE, APT A-103, REDLANDS, CA 92373-4454
(618) 599-9904

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
145435
CA

Other

Enumeration date
06/12/2015
Last updated
06/19/2018
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