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1164559761
JAMES ROBERT ETTELDORF
LOMA LINDA, CA
NPI
1164559761
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 10542)
Enumeration Date
2007-02-28
Last Update Date
2007-07-08
Business Address
Mr. JAMES ROBERT ETTELDORF N.P.
11234 ANDERSON ST
LOMA LINDA, CA 92354-2804
Phone number: 909-558-8514
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Mailing Address
Mr. JAMES ROBERT ETTELDORF N.P.
2242 BLACK OAK PL
RIVERSIDE, CA 92506-4603
Phone number: 951-686-1146
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