Healthcare Provider Details

I. General information

NPI: 1467411058
Provider Name (Legal Business Name): JOCELYN AREVALO MCGRATH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 N RIVERSIDE AVE
RIALTO CA
92376-8069
US

IV. Provider business mailing address

8110 MANGO AVE
FONTANA CA
92335-3603
US

V. Phone/Fax

Practice location:
  • Phone: 909-871-2371
  • Fax: 909-874-0826
Mailing address:
  • Phone: 909-822-1164
  • Fax: 909-357-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA85338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: