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Jisha Pangottil
Primary Care Nurse Practitioner in Ontario, California
NPI 1871073411

Jisha Pangottil is a Primary Care Nurse Practitioner based in Ontario, CA and is specialized in Primary Care. Jisha Pangottil practices in Ontario, CA. The NPI Number for Jisha Pangottil is 1871073411 and holds a License No. NP95009215 (California).

The current practice location address for Jisha Pangottil is 2295 S Vineyard Ave, Ontario, CA and can be reached out via phone at 909-724-3940.

Location: 2295 S Vineyard Ave, Ontario, CA, 91761-7925
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871073411
Provider Name
Jisha Pangottil
Credential
Provider Entity Type
Individual
Gender
Female
Address
2295 S Vineyard Ave, Ontario, CA, 91761-7925
Phone Number
909-724-3940
Fax Number
Provider Enumeration Date
08/14/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2295 S Vineyard Ave
City
Ontario
State
California
Zip
91761-7925
Phone Number
909-724-3940
Fax Number
person
Provider Business Mailing Address Details
Address
2295 S Vineyard Ave
City
Ontario
State
California
Zip
91761-7925
Phone Number
909-724-3940
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
NP95009215 (California)
Definition
Definition to come...
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