DOMINADOR PERALTA MANSAT

ONTARIO, CA
NPI1700500600
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: CA  95022872)
Enumeration Date2022-10-04
Last Update Date2022-10-04
Business Address
DOMINADOR PERALTA MANSAT FNP-C
1910 S ARCHIBALD AVE STE D
ONTARIO, CA 91761-8503
Phone number: 909-348-2556
Mailing Address
DOMINADOR PERALTA MANSAT FNP-C
9415 RETREAT PL
RANCHO CUCAMONGA, CA 91730-9200
Phone number: 909-348-3067