Lasalle Medical Associates | |
1505 W. 17th Street San Bernardino CA 92411 | |
(909) 887-6494 | |
(909) 887-6043 |
Full Name | Lasalle Medical Associates |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 1505 W. 17th Street, San Bernardino, California |
Authorized Official Name and Position | Albert H. Arteaga (CEO/OWNER) |
Authorized Official Contact | 9098900407 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lasalle Medical Associates 1855 W Redlands Blvd 2nd Floor Redlands CA 92373-3145 Ph: (909) 890-0407 | Lasalle Medical Associates 1505 W. 17th Street San Bernardino CA 92411 Ph: (909) 887-6494 |
NPI Number | 1548398142 |
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Provider Enumeration Date | 03/02/2007 |
Last Update Date | 08/23/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548398142 | NPI | - | NPPES |
GR0079091 | Medicaid | CA | |
00A382060 | Other | CA | MEDI-CAL ID NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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