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General NPI Number Information
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NPI Number | 1497452668
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Entity Type | Individual
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Provider Name | CHRISTINE POBLETE PENAFLORIDA NP
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Gender | Female
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 790 THE CITY DR S STE 180
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City | ORANGE
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State | CA
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Zip | 92868-4941
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Country | US
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Telephone | 714-712-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 8041 MERIDIAN ST
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City | CHINO
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State | CA
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Zip | 91708-7677
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Country | US
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Telephone | 714-390-8708
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95024091
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License Number State | CA
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