Most Relevant Information
Provider Data
| NPI Number: | 1003012691 |
| Provider Name: | IRENE BACUS |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 625372 |
Most Important Dates
| Enumeration Date: | 06/21/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
3330 CENTRE LAKE DR
ONTARIO
CA
917611211
Practice Location Phone/Fax
| Phone: | 9099744704 |
| Fax: |
Provider Mailing Location
108 BREEZEWOOD ST
CORONA
CA
928791210
Provider Mailing Phone/Fax
| Phone: | 9512711985 |
| Fax: |