Healthcare Provider Details

I. General information

NPI: 1295231637
Provider Name (Legal Business Name): ISABELLA POSSAGNOLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 INDIANA CT STE 101
REDLANDS CA
92374-2896
US

IV. Provider business mailing address

PO BOX 311
REDLANDS CA
92373-0101
US

V. Phone/Fax

Practice location:
  • Phone: 909-440-6009
  • Fax:
Mailing address:
  • Phone: 909-440-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA175131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: