Individual provider · NPI-1

Marc Abou Assali

Student in an Organized Health Care Education/Training Program · Loma Linda, CA

NPI number1689317265
StatusActive
Last updated in NPPESApr 20, 2022

Details

NPI
1689317265
Entity type
Individual (NPI-1)
Name
Marc Abou Assali
Sex
Male
Sole proprietor
No
Enumeration date
Apr 20, 2022
Certification date
Apr 20, 2022
Last updated
Apr 20, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Phone 909-558-2822

Mailing address

11234 Anderson St
Gme Office Westerly Suite 'C'
Loma Linda, CA 92354-2804

Phone 909-558-2822

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