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1359 N Grand Ave Covina CA 91724-1016 | |
| (626) 430-2900 | |
| (626) 331-0035 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 1359 N Grand Ave, Covina, California |
| Authorized Official Name and Position | Quentin O'brien (AMBULATORY NETWORK, CEO) |
| Authorized Official Contact | 2132889000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1359 N Grand Ave Covina CA 91724-1016 Ph: (626) 430-2900 | 1359 N Grand Ave Covina CA 91724-1016 Ph: (626) 430-2900 |
| NPI Number | 1235663758 |
|---|---|
| Provider Enumeration Date | 04/12/2017 |
| Last Update Date | 06/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235663758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (California) | Primary |
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