Individual
INGRID K GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6177 RIVER CREST DR STE A, RIVERSIDE, CA 92507-0728
(951) 653-4480
Mailing address
11068 WILSON CV, LOMA LINDA, CA 92354-6512
(208) 290-2193
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT37139
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT37139
PT LICENSE
CA
Enumeration date
09/29/2010
Last updated
09/29/2010
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