Individual
EDWARD GICHURU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4121 MELODY ST # 4, LA VERNE, CA 91750-3228
(316) 393-1334
Mailing address
4121 MELODY ST, LA VERNE, CA 91750-3228
(316) 393-1334
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95376874
CA
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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