| Innova Physician Network, Inc. | |
|
1403 N Fair Oaks Ave Ste 3 Pasadena CA 91103-1876 | |
| (626) 398-0354 | |
| Not Available |
| Full Name | Innova Physician Network, Inc. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1403 N Fair Oaks Ave Ste 3, Pasadena, California |
| Authorized Official Name and Position | Carlos G Rodriguez (CEO) |
| Authorized Official Contact | 6263980354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innova Physician Network, Inc. 1403 N Fair Oaks Ave Ste 3 Pasadena CA 91103-1876 Ph: (626) 398-0354 | Innova Physician Network, Inc. 1403 N Fair Oaks Ave Ste 3 Pasadena CA 91103-1876 Ph: (626) 398-0354 |
| NPI Number | 1134704042 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 03/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134704042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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