Healthcare Provider Details

I. General information

NPI: 1821232182
Provider Name (Legal Business Name): POMONA HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 N ORANGE GROVE AVE SUITE 100
POMONA CA
91767-3028
US

IV. Provider business mailing address

11012 VENTURA BLVD SUITE 347
STUDIO CITY CA
91604-3400
US

V. Phone/Fax

Practice location:
  • Phone: 909-342-8751
  • Fax: 909-992-3019
Mailing address:
  • Phone: 909-342-8751
  • Fax: 909-992-3019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA71647
License Number StateCA

VIII. Authorized Official

Name: OLIVER OPPERS AALAMI
Title or Position: PRESIDENT
Credential: MD
Phone: 909-342-8751