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General NPI Number Information
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NPI Number | 1134769896
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Entity Type | Organization
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Legal Business Name | NU WAVE MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/10/2020
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Last Update Date | 01/10/2020
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Provider Practice Location Address
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Address Line | 9390 HESPERIA RD SUITE 7
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City | HESPERIA
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State | CA
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Zip | 92345
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Country | US
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Telephone | 760-998-3550
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Fax | 760-998-3552
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Provider Business Mailing Address
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Address Line | 9390 HESPERIA RD SUITE 7
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City | HESPERIA
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State | CA
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Zip | 92345
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Country | US
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Telephone | 760-998-3550
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Fax | 760-998-3552
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Authorized Official
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Title or Position | CEO
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Name | EMANUEL JEAN PIERRE
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Credential |
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Telephone | 760-998-3550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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