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General NPI Number Information
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NPI Number | 1972159069
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Entity Type | Organization
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Legal Business Name | NIGHTINGALE CLINICAL CARE, PC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 4361 LATHAM ST STE 270
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City | RIVERSIDE
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State | CA
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Zip | 92501-4332
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Country | US
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Telephone | 951-774-0064
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Fax |
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Provider Business Mailing Address
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Address Line | 10690 SAN PABLO AVE
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City | EL CERRITO
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State | CA
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Zip | 94530-2620
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY GEN
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Credential |
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Telephone | 559-977-0953
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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 |
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License Number State |
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