Healthcare Provider Details
I. General information
NPI: 1932832102
Provider Name (Legal Business Name): HEALTHCARE HEROES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2022
Last Update Date: 07/06/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3073 DAPPLEGRAY LN
NORCO CA
92860-4141
US
IV. Provider business mailing address
1439 W CHAPMAN AVE 236
ORANGE CA
92868-2738
US
V. Phone/Fax
- Phone: 714-988-4202
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084B0040X |
| Taxonomy | Behavioral Neurology & Neuropsychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRYSTAL
COLONE
Title or Position: OWNER
Credential: PA
Phone: 951-858-3543