NPI Provider: 1164552378
Contact Name: Mitchell Anitha
Phone: (310) 673-9499
Centinela Valley Ipa Medical Group Information:
Centinela Valley Ipa Medical Group organization have npi 1164552378, taxonomy code is 171W00000X with license number is 171W00000X in . This Business address located in PO Box 4069, Covina, CA 91723 California.
Address: 955 Overland Ct Fl 2, San Dimas, CA 91773
Phone: (909) 971-6717
Taxonomy Code: 171W00000X
License Number: 171W00000X
License Number of State: CA
Primary Taxonomy Switch: Y
Enumeration Date: 3/6/2007
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