Vanessa M Michelena Basantes PA-C

NPI 1053666297 - Physician Assistant - 363A00000X

NPI Details
NPI 1053666297
Gender Female
Enumeration Date 07/13/2012
Last Updated 06/03/2014
Entity Type Individual
Active Over 4 years ago
Practice Location
4904 TAHAN WAY
FONTANA CA, 92336-0428, US
Phone (909) 561-5032
Fax
Business Location
4904 TAHAN WAY
FONTANA CA, 92336-0428, US
Phone (909) 561-5032
Fax
Toxanomy
Taxonomy Code 363A00000X
License State
License Number
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According to our database, Vanessa M Michelena Basantes PA-C NPI is 1053666297, taxonomy code is 363A00000X Vanessa M Michelena Basantes PA-C physically located at 4904 Tahan Way, Fontana CA, 92336-0428. NPI Number Vanessa M Michelena Basantes PA-C has the Individual type.

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1053666297 NPI number is provided on an as is basis without warranty of any kind. 1053666297 is maintained by the National Plan & Provider Enumeration System. The contents of Vanessa M Michelena Basantes PA-C are for informational purposes only.