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Individual

MARYLIN RUTH CRUZ GOULD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7965 SIERRA AVE STE E, FONTANA, CA 92336-3329
(909) 356-4459
Mailing address
7965 SIERRA AVE STE E, FONTANA, CA 92336-3329
(909) 356-4459

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
95004050
CA

Other

Enumeration date
05/25/2016
Last updated
05/25/2016
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