Individual
DOMINADOR PERALTA MANSAT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1910 S ARCHIBALD AVE STE D, ONTARIO, CA 91761-8503
(909) 348-2556
(877) 615-1555
Mailing address
9415 RETREAT PL, RANCHO CUCAMONGA, CA 91730-9200
(909) 348-3067
(877) 615-1555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95022872
CA
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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