| Pvhc At Claremont | |
|
1601 Monte Vista Ave Ste 100 Claremont CA 91711-6601 | |
| (909) 630-7938 | |
| (909) 469-2118 |
| Full Name | Pvhc At Claremont |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 1601 Monte Vista Ave Ste 100, Claremont, California |
| Authorized Official Name and Position | Duane W Styles (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9096307938 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pvhc At Claremont 1601 Monte Vista Ave Ste 100 Claremont CA 91711-6601 Ph: (909) 630-7938 | Pvhc At Claremont 1601 Monte Vista Ave Ste 100 Claremont CA 91711-6601 Ph: (909) 630-7938 |
| NPI Number | 1164668786 |
|---|---|
| Provider Enumeration Date | 01/02/2009 |
| Last Update Date | 07/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164668786 | NPI | - | NPPES |
| 00320034 | Other | CA | STATE OF CALIFORNIA CLP |
| 05D0881917 | Other | CLIA | |
| 1164668786 | Medicaid | CA | |
| GR0083730 | Medicaid | CA | |
| 550000880 | Other | CA | DHS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | 550000880 (California) | Primary |
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