Healthcare Provider Details

I. General information

NPI: 1588401160
Provider Name (Legal Business Name): JOHN DOWNTAIN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST STE A504
LOMA LINDA CA
92350-1716
US

IV. Provider business mailing address

35793 JACK RABBIT LN
MURRIETA CA
92563-7931
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4000
  • Fax:
Mailing address:
  • Phone: 208-704-0241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95002889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: