Provider Demographics
NPI:1477829471
Name:DIOLOLA, REINARD D (RN)
Entity Type:Individual
Prefix:MR
First Name:REINARD
Middle Name:D
Last Name:DIOLOLA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42873 DELLA PL
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-2983
Mailing Address - Country:US
Mailing Address - Phone:760-619-6682
Mailing Address - Fax:
Practice Address - Street 1:42873 DELLA PL
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-2983
Practice Address - Country:US
Practice Address - Phone:760-619-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-24
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA735173163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse