Individual provider · NPI-1

John Gaspar Agtuca, D.O.

Internal Medicine · Riverside, CA

NPI number1306200183
StatusActive
Last updated in NPPESAug 17, 2023

Details

NPI
1306200183
Entity type
Individual (NPI-1)
Name
John Gaspar Agtuca
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Apr 7, 2016
Certification date
Aug 17, 2023
Last updated
Aug 17, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine20A16933CAYes

Practice location

6900 Brockton Ave Ste 100
Riverside, CA 92506-3817

Phone 951-781-3800 · Fax 951-781-1973

Mailing address

Po Box 5089
Norco, CA 92860-8003

Other practice locations

2250 S Main St Ste 106
Corona, CA 92882-2501

Phone 951-371-2703 · Fax 951-735-3296

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