Most Relevant Information
Provider Data
| NPI Number: | 1003379652 |
| Provider Name: | NANTIYA DANGIDANG LVN |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | VN275981 |
Most Important Dates
| Enumeration Date: | 04/10/2019 |
| Last Updated: | 04/10/2019 |
Provider Practice Location
11776 MARIPOSA RD # 103
HESPERIA
CA
923451622
Practice Location Phone/Fax
| Phone: | 7609562462 |
| Fax: | 7609567542 |
Provider Mailing Location
11776 MARIPOSA RD # 103
HESPERIA
CA
923451622
Provider Mailing Phone/Fax
| Phone: | 7609562462 |
| Fax: | 7609567542 |