Provider Demographics
NPI:1790979094
Name:NATIONAL CORNERSTONE HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:NATIONAL CORNERSTONE HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-616-6247
Mailing Address - Street 1:24747 REDLANDS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4026
Mailing Address - Country:US
Mailing Address - Phone:877-616-6247
Mailing Address - Fax:877-777-5717
Practice Address - Street 1:24747 REDLANDS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4026
Practice Address - Country:US
Practice Address - Phone:877-616-6247
Practice Address - Fax:877-777-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAWLS3859332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site