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1710431960
JOHN JAYSON LOPEZ BONGGA
COLTON, CA
NPI
1710431960
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: CA 95000665)
Enumeration Date
2016-08-04
Last Update Date
2021-12-06
Business Address
JOHN JAYSON LOPEZ BONGGA
400 N PEPPER AVE
COLTON, CA 92324-1801
Phone number: 909-580-2440
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Mailing Address
JOHN JAYSON LOPEZ BONGGA
11755 MALAGA DR UNIT 1165
RANCHO CUCAMONGA, CA 91730-7224
Phone number: 909-851-3067
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