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General NPI Number Information
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NPI Number | 1659971042
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Entity Type | Organization
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Legal Business Name | CORONA HEALTH SPECIALTY ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 308 W 6TH ST STE 101
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City | CORONA
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State | CA
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Zip | 92882-3349
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Country | US
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Telephone | 951-737-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 940 N HAVEN AVE STE 18025
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City | ONTARIO
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State | CA
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Zip | 91764-4970
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Country | US
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Telephone | 951-808-6240
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT GUY NELSON
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Credential | M.D.
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Telephone | 951-808-6240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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