Healthcare Provider Details

I. General information

NPI: 1851042055
Provider Name (Legal Business Name): BOB CLARO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11096 FOOTHILL BLVD STE 100
RANCHO CUCAMONGA CA
91730-7629
US

IV. Provider business mailing address

11096 FOOTHILL BLVD STE 100
RANCHO CUCAMONGA CA
91730-7629
US

V. Phone/Fax

Practice location:
  • Phone: 909-582-4665
  • Fax:
Mailing address:
  • Phone: 909-582-4665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018664
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: