| Alta Medical Group Of California | |
|
9836 Foothill Blvd Ste 610 Rancho Cucamonga CA 91730-3660 | |
| (909) 236-0338 | |
| Not Available |
| Full Name | Alta Medical Group Of California |
|---|---|
| Speciality | General Practice |
| Location | 9836 Foothill Blvd Ste 610, Rancho Cucamonga, California |
| Authorized Official Name and Position | Peterson Go (PRESIDENT) |
| Authorized Official Contact | 9092360338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta Medical Group Of California 9836 Foothill Blvd Ste 610 Rancho Cucamonga CA 91730-3660 Ph: (909) 236-0338 | Alta Medical Group Of California 9836 Foothill Blvd Ste 610 Rancho Cucamonga CA 91730-3660 Ph: (909) 236-0338 |
| NPI Number | 1508580523 |
|---|---|
| Provider Enumeration Date | 10/03/2022 |
| Last Update Date | 10/03/2022 |
| Certification Date | 10/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508580523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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