Centinela Valley Ipa Medical Group

NPI 1164552378 - Contractor - 171W00000X

NPI Details
NPI 1164552378
Enumeration Date 03/06/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name ANITHA ANITHA
Position PRESIDENT
Phone (909) 971-6717
Fax
Practice Location
955 OVERLAND CT FL 2
SAN DIMAS CA, 91773-1718, US
Phone (909) 971-6717
Fax
Business Location
PO BOX 4069
COVINA CA, 91723-0469, US
Phone (909) 971-6717
Fax
Toxanomy
Taxonomy Code 171W00000X
License State California
License Number 171W00000X
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According to our database, Centinela Valley Ipa Medical Group NPI is 1164552378, taxonomy code is 171W00000X and license number is 171W00000X, license state is located at California. Centinela Valley Ipa Medical Group physically located at 955 Overland Ct Fl 2, San Dimas CA, 91773-1718. NPI Number 1033115704 has the healthcare provider type.

1164552378 NPI number is provided on an as is basis without warranty of any kind. 1164552378 is maintained by the National Plan & Provider Enumeration System. The contents of Centinela Valley Ipa Medical Group are for informational purposes only.