Individual
AMABELLE JUNE BLAZADO AGUELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 W TOWN AND COUNTRY RD STE 1300, ORANGE, CA 92868-4654
(855) 434-7763
(949) 281-5550
Mailing address
7159 MYRTLE PL, FONTANA, CA 92336-5706
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95021106
CA
Other
Enumeration date
06/06/2022
Last updated
08/01/2022
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