| Pvhc@ Laverne | |
|
2333 Foothill Blvd Ste B La Verne CA 91750-3027 | |
| (909) 392-6501 | |
| (909) 469-2136 |
| Full Name | Pvhc@ Laverne |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 2333 Foothill Blvd Ste B, La Verne, California |
| Authorized Official Name and Position | Michael Deanda (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9098659501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pvhc@ Laverne 1601 Monte Vista Ave Ste 100 Claremont CA 91711-6601 Ph: (909) 865-9501 | Pvhc@ Laverne 2333 Foothill Blvd Ste B La Verne CA 91750-3027 Ph: (909) 392-6501 |
| NPI Number | 1033634373 |
|---|---|
| Provider Enumeration Date | 08/08/2017 |
| Last Update Date | 07/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033634373 | NPI | - | NPPES |
| 1033634373 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
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