Individual
GLENN FORD FERNANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
26437 HOBART CIR, MORENO VALLEY, CA 92555-2553
(951) 236-9910
Mailing address
26437 HOBART CIR, MORENO VALLEY, CA 92555-2553
(951) 236-9910
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
286155
CA
Other
Enumeration date
09/26/2015
Last updated
09/26/2015
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