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General NPI Number Information
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NPI Number | 1740625607
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Entity Type | Organization
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Legal Business Name | KATRINA PLATT DO PC
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Dates
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Enumeration Date | 05/06/2013
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Last Update Date | 08/26/2013
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Provider Practice Location Address
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Address Line | 2388 GRACE ST
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City | RIVERSIDE
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State | CA
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Zip | 92504-4909
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Country | US
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Telephone | 909-641-6708
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Fax |
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Provider Business Mailing Address
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Address Line | 5 E CITRUS AVE SUITE 209
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City | REDLANDS
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State | CA
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Zip | 92373-4736
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Country | US
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Telephone | 909-307-6007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATRINA PLATT
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Credential | D.O.
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Telephone | 909-641-6708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 20A10988
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License Number State | CA
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