Individual
MISS MAELEDAH RUBALCAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1205 RENAISSANCE PKWY STE 240, RIALTO, CA 92376-2418
(909) 746-5000
Mailing address
17840 RIMHURST CT, SAN BERNARDINO, CA 92407-1200
(909) 631-8271
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
90857
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90857
—
CA
Enumeration date
06/29/2020
Last updated
06/29/2020
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