Individual provider · Type 1 NPI

Lou Mizelle Delacruz Tanwangco, PA-C

Medical Physician Assistant · San Bernardino, CA

NPI number 1609993708 Active

Practice location

1906 Commercenter E Ste 100
San Bernardino, CA 92408-3423

Call (909) 478-7776 Map

Fax (909) 478-7768

Mailing address

491 S La Salle St
Redlands, CA 92374-6472

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA17755 (CA)

Medical Physician Assistant: Definition to come...

2 other providers at this address

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About NPI 1609993708

Lou Mizelle Delacruz Tanwangco, PA-C's National Provider Identifier is 1609993708, issued on Mar 23, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in San Bernardino, CA. The record was last updated on Dec 1, 2011.