Individual
DIANE HELEN PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1019 S DANEHURST AVE, GLENDORA, CA 91740-4855
(626) 963-9214
Mailing address
1019 S DANEHURST AVE, GLENDORA, CA 91740-4855
(626) 963-9214
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
403521
CA
Other
Enumeration date
09/21/2007
Last updated
09/21/2007
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