Individual
DORA KISSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1428 N WATERMAN AVE STE B, SAN BERNARDINO, CA 92404-5382
(909) 888-7180
Mailing address
1426 TAHOE ST, BEAUMONT, CA 92223-3158
(909) 435-9199
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
9051
CA
367A00000X
Advanced Practice Midwife
Primary
826
CA
Other
Enumeration date
05/25/2012
Last updated
06/01/2016
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