Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95004716 | CA |
NPI | 1003344391 |
---|---|
Provider Name | Rachel Nuguid Taruc-Carlos |
First Address | Chino, CA 91708-9231 |
Second Address | Ontario, CA 91762-3456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2017 |
Last Update Date | 03/12/2021 |