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Individual

RUEL REY O ALAVANZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, RT

Contact information

Practice address
11606 ANDERSON ST, LOMA LINDA, CA 92354-3457
(909) 536-9169
Mailing address
1438 S MT VIEW AVE, SAN BERNARDINO, CA 92408-3132
(909) 536-9169

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
793979
CA
163WH0200X
Home Health Registered Nurse
Primary
793979
CA

Other

Enumeration date
04/25/2020
Last updated
04/25/2020
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