Healthcare Provider Details

I. General information

NPI: 1396370391
Provider Name (Legal Business Name): LPW AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2020
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N MOUNTAIN AVE STE 201B
UPLAND CA
91786-5714
US

IV. Provider business mailing address

222 N MOUNTAIN AVE STE 201B
UPLAND CA
91786-5714
US

V. Phone/Fax

Practice location:
  • Phone: 909-256-3039
  • Fax: 909-727-8223
Mailing address:
  • Phone: 909-256-3039
  • Fax: 909-727-8223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREN HOBB
Title or Position: CEO
Credential:
Phone: 909-256-3039