Individual provider · Type 1 NPI
Dominador Peralta Mansat Jr., FNP-C
Family Nurse Practitioner · Ontario, CA
NPI number
1700500600
Active
Practice location
1910 S Archibald Ave Ste D
Ontario, CA 91761-8503
Fax (877) 615-1555
Mailing address
9415 Retreat Pl
Rancho Cucamonga, CA 91730-9200
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 95022872 (CA) |
Family Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1700500600
Dominador Peralta Mansat Jr., FNP-C's National Provider Identifier is 1700500600, issued on Oct 4, 2022. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Ontario, CA. The record was last updated on Oct 4, 2022.