| Generoso S Nery M D Inc | |
|
1183 E Foothill Blvd Suite 135 Upland CA 91786-4079 | |
| (909) 931-1368 | |
| (909) 931-1372 |
| Full Name | Generoso S Nery M D Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1183 E Foothill Blvd, Upland, California |
| Authorized Official Name and Position | Generoso Santos Nery (PRESIDENT) |
| Authorized Official Contact | 9099311368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Generoso S Nery M D Inc 1183 E Foothill Blvd Suite 135 Upland CA 91786-4079 Ph: (909) 931-1368 | Generoso S Nery M D Inc 1183 E Foothill Blvd Suite 135 Upland CA 91786-4079 Ph: (909) 931-1368 |
| NPI Number | 1164500559 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164500559 | NPI | - | NPPES |
| 00A310070 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A31007 (California) | Primary |
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