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830 S. Citrus Ave Suite 201 Azusa CA 91702 | |
| (626) 974-1441 | |
| (626) 974-1522 |
| Full Name | |
|---|---|
| Speciality | Pain Medicine - Pain Medicine |
| Location | 830 S. Citrus Ave, Azusa, California |
| Authorized Official Name and Position | Clayton A. Varga (CEO) |
| Authorized Official Contact | 6266961400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 515800 Los Angeles CA 90051-5800 Ph: (909) 493-3800 | 830 S. Citrus Ave Suite 201 Azusa CA 91702 Ph: (626) 974-1441 |
| NPI Number | 1417039926 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 04/20/2020 |
| Certification Date | 04/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417039926 | NPI | - | NPPES |
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