Provider Information for 1366484909
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SAN GABRIEL VALLEY MEDICAL CENTER
Other Names:Doing Business As:SAN GABRIEL VALLEY MEDICAL CENTEROrganization Subpart: NO
NPI: 1366484909
Last Updated: 2013-06-23
Certification Date:
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Details
Name | Value | ||||||||||||
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NPI | 1366484909 | ||||||||||||
Enumeration Date | 2006-06-11 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
Authorized Official Information | Name: HOUSHANG ABD Title: CFO Phone: 6265700612 | ||||||||||||
Mailing Address | 438 W LAS TUNAS DR SAN GABRIEL, CA 91776-1216 United States Phone: 626-570-6640 | Fax:626-457-7153 | ||||||||||||
Primary Practice Address | 438 W LAS TUNAS DR SAN GABRIEL, CA 91776-1216 United States Phone: 626-570-6640 | Fax:626-457-7153 | ||||||||||||
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