Individual
JUAN CORNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1622 PALERMO DR, RIVERSIDE, CA 92507-2393
(562) 685-4610
(951) 213-6898
Mailing address
1622 PALERMO DR, RIVERSIDE, CA 92507-2393
(562) 685-4610
(951) 213-6898
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
336425651
CA
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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