Theresa A Longo MD

NPI 1902990518 - Pediatrics - 2080P0203X

NPI Details
NPI 1902990518
Gender Female
Enumeration Date 10/03/2006
Last Updated 02/01/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
17575 WICKER WAY
RIVERSIDE CA, 92504-9563, US
Phone (951) 780-9389
Fax (951) 780-9389
Business Location
602 W UNIVERSITY AVE
PROVIDER ENROLLMENT - NCWY
URBANA CA, 61801-2530, US
Phone (217) 383-6792
Fax (217) 326-2856
Toxanomy
Taxonomy Code 2080P0203X
License State California
License Number G59848
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According to our database, Theresa A Longo MD NPI is 1902990518, taxonomy code is 2080P0203X and license number is G59848, license state is located at California. Theresa A Longo MD physically located at 17575 Wicker Way, Riverside CA, 92504-9563. NPI Number Theresa A Longo MD has the Individual type.

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1902990518 NPI number is provided on an as is basis without warranty of any kind. 1902990518 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa A Longo MD are for informational purposes only.