Healthcare Provider Details

I. General information

NPI: 1669780581
Provider Name (Legal Business Name): ERNESTO FRANCO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 3RD ST
LA VERNE CA
91750-5201
US

IV. Provider business mailing address

1350 3RD ST
LA VERNE CA
91750-5201
US

V. Phone/Fax

Practice location:
  • Phone: 909-593-2581
  • Fax:
Mailing address:
  • Phone: 909-593-2581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: