Brian Dertli
Student in an Organized Health Care Education/Training Program in Pomona, CA. Individual provider (NPI-1).
NPI number1689367682
StatusActive
Last updated in NPPESMay 26, 2023
Details
- NPI
- 1689367682
- Entity type
- Individual (NPI-1)
- Name
- Brian Dertli
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 26, 2023
- Certification date
- May 26, 2023
- Last updated
- May 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
309 E 2nd StPomona, CA 91766-1854
Phone 909-469-5589
Mailing address
309 E 2nd StPomona, CA 91766-1854
Phone 909-469-5589
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All 1,059 Student in an Organized Health Care Education/Training Program providers in Pomona · All 6,044 providers in Pomona
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