Healthcare Provider Details

I. General information

NPI: 1750738613
Provider Name (Legal Business Name): RMS CHERUBIM HEALTH CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 ARCHIBALD AVE STE 230
RANCHO CUCAMONGA CA
91730-3672
US

IV. Provider business mailing address

PO BOX 394
FONTANA CA
92334-0394
US

V. Phone/Fax

Practice location:
  • Phone: 909-587-9040
  • Fax: 888-818-7091
Mailing address:
  • Phone: 909-587-9040
  • Fax: 888-818-7091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21547
License Number StateCA

VIII. Authorized Official

Name: DR. RELYNDO MANALO SALCEDO
Title or Position: CEO/PRESIDENT
Credential: DNP
Phone: 909-587-9040