Organization · NPI-2

360 Health Dce, INC.

Preferred Provider Organization · Riverside, CA

NPI number1295320745
StatusActive
Last updated in NPPESMar 6, 2021

Details

NPI
1295320745
Entity type
Organization (NPI-2)
Legal business name
360 Health Dce, INC.
Organization subpart
No
Enumeration date
Mar 6, 2021
Certification date
Mar 6, 2021
Last updated
Mar 6, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
305R00000X Preferred Provider Organization––Yes

Practice location

3660 Park Sierra Dr Ste 110
Riverside, CA 92505-3071

Phone 951-637-9935 · Fax 951-637-0608

Mailing address

3660 Park Sierra Dr Ste 110
Riverside, CA 92505-3071

Phone 951-637-9935

Authorized official

Vanessa Ho
Chief Medical Officer
9512333312

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