Organization · NPI-2

Reymundo Nour

Clinic/Center · Indio, CA

NPI number1447598222
StatusActive
Last updated in NPPESJun 19, 2014

Details

NPI
1447598222
Entity type
Organization (NPI-2)
Legal business name
Reymundo Nour
Organization subpart
No
Enumeration date
Jan 29, 2013
Last updated
Jun 19, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/CenterCLR00343403CAYes
291U00000X Clinical Medical Laboratory––
363L00000X Nurse PractitionerCLR00343403CA

Other names

  • Medical Lab Co. (Doing Business As)

Practice location

81626 Us Highway 111
Indio, CA 92201-5413

Phone 760-600-5825

Mailing address

81626 Us Highway 111
Indio, CA 92201-5413

Phone 760-600-5825

Authorized official

Reymundo Nour
Manager
7606005825

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