Individual provider · Type 1 NPI
Roger Michael Gustafson, N.P.
Adult Health Nurse Practitioner · Loma Linda, CA
NPI number
1396766077
Active
Practice location
11201 Benton St
Loma Linda, CA 92357-1000
Mailing address
1270 Mohave Dr
Colton, CA 92324-4740
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 475764 (CA) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1396766077
Roger Michael Gustafson, N.P.'s National Provider Identifier is 1396766077, issued on Jul 21, 2006. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Loma Linda, CA. The record was last updated on Jul 8, 2007.