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General NPI Number Information
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NPI Number | 1265737043
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Entity Type | Organization
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Legal Business Name | PUEBLO MEDICAL CENTER INC
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 8045 CERRITOS AVE
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City | STANTON
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State | CA
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Zip | 90680-2436
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Country | US
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Telephone | 714-828-2444
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Fax | 714-816-0529
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Provider Business Mailing Address
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Address Line | 8045 CERRITOS AVE
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City | STANTON
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State | CA
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Zip | 90680-2436
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Country | US
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Telephone | 714-828-2444
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Fax | 714-816-0529
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES ANGELO SHARKOFF
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Credential | M.D.
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Telephone | 714-828-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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