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255 E Bonita Ave Bldg 1a Pomona CA 91767-1923 | |
| (909) 450-0377 | |
| (909) 450-0356 |
| Full Name | |
|---|---|
| Speciality | Pain Medicine - Pain Medicine |
| Location | 255 E Bonita Ave Bldg 1a, Pomona, 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 90051-3100 Ph: (909) 493-3800 | 255 E Bonita Ave Bldg 1a Pomona CA 91767-1923 Ph: (909) 450-0377 |
| NPI Number | 1356850648 |
|---|---|
| Provider Enumeration Date | 09/29/2017 |
| Last Update Date | 01/18/2021 |
| Certification Date | 01/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356850648 | NPI | - | NPPES |
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