Healthcare Provider Details

I. General information

NPI: 1427969658
Provider Name (Legal Business Name): RANCHO MCO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10370 COMMERCE CENTER DR STE B-100
RANCHO CUCAMONGA CA
91730-5806
US

IV. Provider business mailing address

10370 COMMERCE CENTER DR STE B-100
RANCHO CUCAMONGA CA
91730-5806
US

V. Phone/Fax

Practice location:
  • Phone: 909-283-7599
  • Fax:
Mailing address:
  • Phone: 909-283-7599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOHN BROWN
Title or Position: PRESIDENT
Credential:
Phone: 760-889-0113