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NPI Code Detail

MEDICARE: CHAD NATHAN CRUZ

MEDICARE: CHAD NATHAN CRUZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse726632CA

General Provider Information

NPI Number : 1518818772
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAD NATHAN CRUZ
Provider Business Mailing Address
First Line : 1242 MAGNOLIA AVE
Second Line :
City : REDLANDS
State : CA
Zip : 92373-4902
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26001 REDLANDS BLVD
Second Line :
City : REDLANDS
State : CA
Zip : 92373-7762
Country : US
Telephone Number : 909-825-7084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2026
Last Update Date : 02/04/2026

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Directions to “ CHAD NATHAN CRUZ ” Practice Location

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