Healthcare Provider Details

I. General information

NPI: 1619374741
Provider Name (Legal Business Name): RMS CHERUBIM HEALTH CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2014
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6572 TOKAY AVE
FONTANA CA
92336-1337
US

IV. Provider business mailing address

6572 TOKAY AVE
FONTANA CA
92336-1337
US

V. Phone/Fax

Practice location:
  • Phone: 909-471-6138
  • Fax:
Mailing address:
  • Phone: 909-471-6138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21547
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RELYNDO SALCEDO
Title or Position: PRESIDENT
Credential: NP
Phone: 909-471-6138