SHANE PARK

LOMA LINDA, CA
NPI1629520127
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: CA  95000619)
Enumeration Date2016-10-31
Last Update Date2016-11-18
Business Address
-- SHANE PARK CRNA
11234 ANDERSON STREET
LOMA LINDA, CA 92354
Phone number: 213-700-0178
Mailing Address
-- SHANE PARK CRNA
11234 ANDERSON ST
LOMA LINDA, CA 92354-2804
Phone number: 213-700-0178
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