Individual
MR. REYNALDO MEJIA GAMO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
250 S G ST, SAN BERNARDINO, CA 92410-3320
(909) 382-7100
Mailing address
250 S G ST, SAN BERNARDINO, CA 92410-3320
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
755459
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95026561
CA
Other
Enumeration date
02/11/2021
Last updated
05/23/2024
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