Individual
MR. DODJIE SANTOS HILARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1330 W RAMSEY ST, BANNING, CA 92220-4477
(951) 849-7142
(951) 849-1762
Mailing address
PO BOX 54130, LOS ANGELES, CA 90054-0130
(951) 687-3400
(951) 687-7630
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
644612
CA
163WW0000X
Wound Care Registered Nurse
NP-23566
CA
363LF0000X
Family Nurse Practitioner
Primary
23566
CA
Other
Enumeration date
08/23/2013
Last updated
06/15/2021
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