Healthcare Provider Details

I. General information

NPI: 1972516649
Provider Name (Legal Business Name): FILOMENA S. PASCUAL, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8710 MONROE CT STE. # 200
RANCHO CUCAMONGA CA
91730-4883
US

IV. Provider business mailing address

8710 MONROE CT STE. # 200
RANCHO CUCAMONGA CA
91730-4883
US

V. Phone/Fax

Practice location:
  • Phone: 909-481-9515
  • Fax: 909-481-9520
Mailing address:
  • Phone: 909-481-9515
  • Fax: 909-481-9520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA42652
License Number StateCA

VIII. Authorized Official

Name: DR. FILOMENA SORONGON PASCUAL
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 909-481-9515