Individual
HEDAR TAHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
495 E HOLT AVE, POMONA, CA 91767-5539
(909) 469-9534
Mailing address
495 E HOLT AVE, POMONA, CA 91767-5539
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
763946
CA
251J00000X
Nursing Care Agency
763946
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
763946
RN LICENSE
CA
Enumeration date
11/21/2022
Last updated
11/21/2022
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