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437 S Cataract Ave Ste 3 San Dimas CA 91773-2973 | |
| (909) 305-1948 | |
| (310) 321-3492 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 437 S Cataract Ave Ste 3, San Dimas, California |
| Authorized Official Name and Position | Noemi Garcia Vasquez (AVP CONTRACT & REVENUE MANAGEMENT) |
| Authorized Official Contact | 3232954555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5300 Angeles Vista Blvd View Park CA 90043-1648 Ph: (323) 295-4555 | 437 S Cataract Ave Ste 3 San Dimas CA 91773-2973 Ph: (909) 305-1948 |
| NPI Number | 1427519784 |
|---|---|
| Provider Enumeration Date | 03/28/2019 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427519784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Secondary |
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