1407438948 NPI number — A&G INFUSION NURSING SERVICES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407438948 NPI number — A&G INFUSION NURSING SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A&G INFUSION NURSING SERVICES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407438948
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12625 FREDERICK ST STE E8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORENO VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92553-5253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-703-5766
Provider Business Mailing Address Fax Number:
714-733-7468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11271 SHOWDOWN LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORENO VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92557-4816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-703-5766
Provider Business Practice Location Address Fax Number:
951-379-1246
Provider Enumeration Date:
04/23/2021

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
ANGELICA
Authorized Official Middle Name:
MARIA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
951-703-5766

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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