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General NPI Number Information
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NPI Number | 1437631405
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Entity Type | Individual
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Provider Name | CLORINDA GLORIA BENAVIDEZ RRT/SDS
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 2055 KELLOGG AVE
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City | CORONA
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State | CA
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Zip | 92879-3111
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Country | US
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Telephone | 951-898-7480
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Fax | 951-898-7320
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Provider Business Mailing Address
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Address Line | 5853 RIDGEGATE DR
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City | CHINO HILLS
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State | CA
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Zip | 91709-3257
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Country | US
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Telephone | 909-393-0313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 085
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License Number State | CA
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