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Individual

MR. RELLY MER FUENTEBELLA SEGOVIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
1331 W AVENUE J STE 202, LANCASTER, CA 93534-2954
(661) 529-7550
(661) 529-7560
Mailing address
41916 MONTANA DR, PALMDALE, CA 93551-1643
(727) 366-0274

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95022340
CA

Other

Enumeration date
08/26/2022
Last updated
08/26/2022
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