| Atlas19 Llc | |
|
100 S San Gabriel Blvd San Gabriel CA 91776-1645 | |
| (626) 628-8008 | |
| Not Available |
| Full Name | Atlas19 Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 100 S San Gabriel Blvd, San Gabriel, California |
| Authorized Official Name and Position | Weston Suh (SOLE MEMBER) |
| Authorized Official Contact | 6266288008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlas19 Llc 2275 Huntington Dr # 314 San Marino CA 91108-2640 Ph: (626) 628-8008 | Atlas19 Llc 100 S San Gabriel Blvd San Gabriel CA 91776-1645 Ph: (626) 628-8008 |
| NPI Number | 1124612775 |
|---|---|
| Provider Enumeration Date | 02/24/2021 |
| Last Update Date | 02/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124612775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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