FONTAINE WILLIS

Driver

Active Individual
NPI: 1184215550

Practice Address

4420 N VARSITY AVE APT 1040
San Bernardino, CA 92407

Phone: (213) 949-6845

Specialties

Specialty Code Primary License
Driver 172A00000X Yes Y7940726 (CA)

Frequently Asked Questions

NPI 1184215550 is the National Provider Identifier for FONTAINE WILLIS, a Driver provider located in San Bernardino, CA. This NPI was enumerated on January 28, 2021.
FONTAINE WILLIS practices at 4420 N VARSITY AVE APT 1040, San Bernardino, CA 92407.

Quick Facts

NPI
1184215550
Type
Individual
Enumerated
Jan 28, 2021
Last Updated
Jan 28, 2021

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