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General NPI Number Information
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NPI Number | 1780356295
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Entity Type | Individual
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Provider Name | RONELA KIMBERLY MOLDOVAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2021
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 11234 ANDERSON ST.
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City | LOMA LINDA
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State | CA
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Zip | 92354
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Country | US
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Telephone | 909-558-1254
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Fax |
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Provider Business Mailing Address
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Address Line | 26355 SNOWDEN AVE
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City | REDLANDS
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State | CA
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Zip | 92374
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Country | US
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Telephone | 909-435-8267
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 35014
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License Number State | CA
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