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56925 Yucca Trl Number 232 Yucca Valley CA 92284-7913 | |
| (760) 401-2502 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 56925 Yucca Trl, Yucca Valley, California |
| Authorized Official Name and Position | Edith Ann Jones-poland (OWNER) |
| Authorized Official Contact | 7604012502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
56925 Yucca Trl Number 232 Yucca Valley CA 92284-7913 Ph: (760) 401-2502 | 56925 Yucca Trl Number 232 Yucca Valley CA 92284-7913 Ph: (760) 401-2502 |
| NPI Number | 1083748032 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 12/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083748032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A76482 (California) | Primary |
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