Individual
DAVE DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3145
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3145
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
492736
CA
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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