Amanda Dora Blanco, | |
242 W 4th St, San Dimas, CA 91773-2125 | |
(626) 905-1569 | |
Not Available |
Full Name | Amanda Dora Blanco |
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Gender | Female |
Speciality | Registered Nurse |
Location | 242 W 4th St, San Dimas, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144901349 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163WC0200X | Registered Nurse - Critical Care Medicine | 95065011 (California) | Secondary |
163W00000X | Registered Nurse | 95065011 (California) | Primary |
Entity Name | Faculty Physicians And Surgeons Of Llusm |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
Mailing Address | Practice Location Address |
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Amanda Dora Blanco, 242 W 4th St, San Dimas, CA 91773-2125 Ph: () - | Amanda Dora Blanco, 242 W 4th St, San Dimas, CA 91773-2125 Ph: (626) 905-1569 |
Mrs. Lori Longmeyer, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1350 W Covina Blvd, San Dimas, CA 91773 Phone: 909-599-6811 | |
Janice Floria Valledor, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1350 W Covina Blvd, San Dimas, CA 91773 Phone: 909-599-6811 | |
Banu Kaizad Anklesaria, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1086 W Arrow Hwy, San Dimas, CA 91773 Phone: 909-305-1352 | |
Teresa Schmook, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1350 W Covina Blvd, San Dimas, CA 91773 Phone: 909-599-6811 | |
Maria Norma Velvick, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1350 W Covina Blvd, San Dimas, CA 91773 Phone: 909-599-6811 | |
Mrs. Ana Carolina Cortes, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 135 Calle Renata, San Dimas, CA 91773 Phone: 909-638-6028 |