Healthcare Provider Details

I. General information

NPI: 1205144375
Provider Name (Legal Business Name): ARTHER MED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 W FOOTHILL BLVD STE 101
RIALTO CA
92376-4731
US

IV. Provider business mailing address

851 W FOOTHILL BLVD STE 101
RIALTO CA
92376-4731
US

V. Phone/Fax

Practice location:
  • Phone: 909-873-3876
  • Fax: 909-873-4180
Mailing address:
  • Phone: 909-873-3876
  • Fax: 909-873-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number00A636270
License Number StateCA

VIII. Authorized Official

Name: MRS. EDNA ARTEAGA-HERNANDEZ
Title or Position: DOCTOR
Credential: M.D
Phone: 909-873-3876