Individual
DENISE MAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11234 ANDERSON ST RM 4438, LOMA LINDA, CA 92354-2804
(909) 630-6844
(909) 558-0885
Mailing address
11234 ANDERSON ST RM 4438, LOMA LINDA, CA 92354-2804
(909) 630-6844
(909) 558-0885
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
808314
CA
363LF0000X
Family Nurse Practitioner
Primary
95006508
CA
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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