Healthcare Provider Details

I. General information

NPI: 1316071590
Provider Name (Legal Business Name): MRS. DENICE CAHILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E HOLT AVE STE B
POMONA CA
91767-5407
US

IV. Provider business mailing address

17150 RIDGE CANYON DR
RIVERSIDE CA
92506-5768
US

V. Phone/Fax

Practice location:
  • Phone: 909-620-2521
  • Fax: 909-620-9793
Mailing address:
  • Phone: 909-620-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: