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General NPI Number Information
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NPI Number | 1679329080
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Entity Type | Organization
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Legal Business Name | JENKINS FAMILY NURSING MEDICAL PRACTICE, INC
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 3333 CONCOURS STE 4200
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City | ONTARIO
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State | CA
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Zip | 91764-6547
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Country | US
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Telephone | 909-230-8930
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Fax | 951-379-7001
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Provider Business Mailing Address
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Address Line | 3333 CONCOURS STE 4200
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City | ONTARIO
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State | CA
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Zip | 91764-6547
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Country | US
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Telephone | 92-308-9309
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Fax | 951-379-7001
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Authorized Official
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Title or Position | CEO/ OWNER
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Name | CHARLOTTE JENKINS
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Credential | FNP
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Telephone | 909-230-8930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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