Agustin, Elaine Grace

Agustin, Elaine Grace is an individual health care provider with primary practice located at 401 E Highland Ave Suite 551, San Bernardino CA 92404-3803. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Agustin, Elaine Grace can be contacted via phone (909) 882-9150.

Contact Information

Primary practice address
401 E Highland Ave Suite 551 San Bernardino CA 92404-3803
Phone: (909) 882-9150
Fax: (909) 883-8972
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP 13423 California

Profile Details

NPI number 1992837843
LBN Legal business name Agustin, Elaine Grace
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2007
Last updated Jan 21st, 2021 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1992837843 NPPES
California Other RN 549365 REGISTERED NURSE
California Other NP 13423 REGISTERED NURSE

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