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General NPI Number Information
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NPI Number | 1720802143
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Entity Type | Individual
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Provider Name | SEBASTIAN S BELTRAN
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Gender | Male
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 4275 LEMON ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-3844
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Country | US
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Telephone | 951-788-3471
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Fax |
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Provider Business Mailing Address
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Address Line | 3275 PINE ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-2336
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Country | US
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Telephone | 951-497-9258
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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