Healthcare Provider Details

I. General information

NPI: 1679738496
Provider Name (Legal Business Name): MARIA RINCON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 N GRAND AVE STE D
COVINA CA
91724-1552
US

IV. Provider business mailing address

758 W CENTER ST
POMONA CA
91768-3503
US

V. Phone/Fax

Practice location:
  • Phone: 626-967-1667
  • Fax:
Mailing address:
  • Phone: 626-691-1209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: