Provider Information for 1871163360
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CRISTIAN M IORDAN
Sex: Male
NPI: 1871163360
Last Updated: 2021-06-28
Certification Date: 2021-06-28
Certification Date: 2021-06-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1871163360 | ||||||||
| Enumeration Date | 2021-06-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 702 GOLF AVE BEAUMONT, CA 92223-7149 United States Phone: 909-553-3996 | Fax: | ||||||||
| Primary Practice Address | 11057 HILL DR LOMA LINDA, CA 92354-2799 United States Phone: 909-796-0222 | Fax: | ||||||||
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