| Body 101 | |
|
1822a E Route 66 # 279 Glendora CA 91740-3868 | |
| (909) 399-0040 | |
| Not Available |
| Full Name | Body 101 |
|---|---|
| Speciality | Internal Medicine |
| Location | 1822a E Route 66 # 279, Glendora, California |
| Authorized Official Name and Position | Stephanie Rade (D.O) |
| Authorized Official Contact | 9093990040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Body 101 Po Box 486 Monrovia CA 91017-0486 Ph: (909) 399-0040 | Body 101 1822a E Route 66 # 279 Glendora CA 91740-3868 Ph: (909) 399-0040 |
| NPI Number | 1134398332 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 02/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134398332 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 20A8673 (California) | Primary |
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