Doctor Name: | MR. RUSSELL NATHAN ALMENDAREZ |
NPI Number: | 1366547036 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. A. |
License Number: | AT 6636 |
Business Practice Address: | 11201 Benton Street Loma Linda, CA - 92357 |
Business Phone Number: | 9098257084 |
Business Fax Number: | |
Mailing Address: | 34283 Via Buena Drive, YUCAIPA |
State: | CA |
Postal Code: | 923992520 |
Phone Number: | 9097902039 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | AT 6636 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |