Fernando Botero
Non-emergency Medical Transport (VAN) in Fontana, CA. Individual provider (NPI-1).
NPI number1982163465
StatusActive
Last updated in NPPESApr 9, 2019
Details
- NPI
- 1982163465
- Entity type
- Individual (NPI-1)
- Name
- Fernando Botero
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 14, 2019
- Last updated
- Apr 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 343900000X | Non-emergency Medical Transport (VAN) | 81-4404308 | CA | Yes |
| 347E00000X | Transportation Broker | 81-4404308 | CA |
Practice location
15220 Fox Ridge DrFontana, CA 92336-0230
Phone 909-815-0166
Mailing address
15220 Fox Ridge DrFontana, CA 92336-0230
Phone 909-815-0166
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