Fuentes, Elisa Dali

Fuentes, Elisa Dali is an individual health care provider with primary practice located at 275 W Hospitality Ln Ste 100 , San Bernardino CA 92408-3238. She recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Gerontology, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Fuentes, Elisa Dali can be contacted via phone (909) 567-2221.

Contact Information

Primary practice address
275 W Hospitality Ln Ste 100 San Bernardino CA 92408-3238
Phone: (909) 567-2221
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation 225XP0019X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Gerontology 225XG0600X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X

Profile Details

NPI number 1871273979
LBN Legal business name Fuentes, Elisa Dali
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2023
Last updated Jul 24th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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