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1234 Foothill Blvd Laverne CA 91750 | |
(909) 596-4879 | |
(909) 670-0219 |
Full Name | |
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Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
Location | 1234 Foothill Blvd, Laverne, California |
Authorized Official Name and Position | Dawn Glover (MANAGER) |
Authorized Official Contact | 9095964879 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1234 Foothill Blvd Laverne CA 91750 Ph: (909) 596-4879 | 1234 Foothill Blvd Laverne CA 91750 Ph: (909) 596-4879 |
NPI Number | 1780768325 |
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Provider Enumeration Date | 10/24/2006 |
Last Update Date | 02/26/2014 |
Identifier | Type | State | Issuer |
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1780768325 | NPI | - | NPPES |
GR0046920 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |