Individual
RUDHEL AGTANG BANIAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 E WREN AVE, VISALIA, CA 93291-2103
(559) 563-1949
Mailing address
401 E WREN AVE, VISALIA, CA 93291-2103
(559) 563-1949
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
95033198
CA
Other
Enumeration date
06/07/2020
Last updated
06/07/2020
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