Healthcare Provider Details

I. General information

NPI: 1003721366
Provider Name (Legal Business Name): JUAN MIGUEL GARGANERA POSADAS GARGANERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26001 REDLANDS BLVD
REDLANDS CA
92373-7762
US

IV. Provider business mailing address

26001 REDLANDS BLVD
REDLANDS CA
92373-7762
US

V. Phone/Fax

Practice location:
  • Phone: 909-478-7083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN-86868
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: