Individual provider · Type 1 NPI
Jeffrey Andrew Van Gorder
Lodging Provider · La Verne, CA
NPI number
1760290894
Active
Practice location
6425 Canterwood Rd
La Verne, CA 91750-1211
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Lodging Provider Primary | 177F00000X | None listed |
Lodging Provider: A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
About NPI 1760290894
Jeffrey Andrew Van Gorder's National Provider Identifier is 1760290894, issued on Dec 20, 2024. The primary taxonomy on file is Lodging Provider (177F00000X), and the practice location is in La Verne, CA. The record was last updated on Dec 20, 2024.