Provider Demographics
NPI:1982329579
Name:TULOD, EDUARDO DELA CRUZ JR (NP)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:DELA CRUZ
Last Name:TULOD
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26221 CITRON ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-6574
Mailing Address - Country:US
Mailing Address - Phone:909-556-9482
Mailing Address - Fax:
Practice Address - Street 1:49305 GRAPEFRUIT BLVD STE 1
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1490
Practice Address - Country:US
Practice Address - Phone:909-556-9482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95164624163W00000X
CA556669364SC1501X
CA95022602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health