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NPI Code Detail

MEDICARE: DONNA LEFFLER HEALTH CLINIC

MEDICARE: DONNA LEFFLER HEALTH CLINIC
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
1261QC1500XCommunity Health Clinic/CenterCH02077CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689884504
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONNA LEFFLER HEALTH CLINIC
Provider Business Mailing Address
First Line : 815 S WILLOW AVE
Second Line :
City : RIALTO
State : CA
Zip : 92376-6934
Country : US
Telephone Number : 909-820-7785
Fax Number : 909-820-7770
Provider Business Practice Location Address
First Line : 815 S WILLOW AVE
Second Line :
City : RIALTO
State : CA
Zip : 92376-6934
Country : US
Telephone Number : 909-820-7785
Fax Number : 909-820-7770
Authorized Official
Title or Position : DIRECTOR OF HEALTH SERVICES
Name : MRS. ANNETTE MCCORMICK WITKOFSKY
Credential : RNPNP
Telephone Number : 909-820-8775
Provider Enumeration Date : 05/22/2007
Last Update Date : 08/22/2020

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1265286611 — MRS. CECILIA GATCHALIAN GUTIERREZ MSN, RN
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RIALTO, CA
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Practice Fax: 909-820-8151
1528816097 — MR. EJERE OKORIE RN
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1922857846 — CYNTHIA NWADIKE MSN, RN
Practice Location Address:
815 S WILLOW AVE
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92376-6934
Practice Phone: 909-820-8150
Practice Fax: 909-820-8151

Directions to “DONNA LEFFLER HEALTH CLINIC ” Practice Location

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