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General NPI Number Information
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NPI Number | 1285739979
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Entity Type | Organization
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Legal Business Name | RICARDO DI SARLI MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/13/2018
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Provider Practice Location Address
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Address Line | 1568 N ORANGE GROVE
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City | POMONA
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State | CA
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Zip | 91767
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Country | US
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Telephone | 909-868-6666
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Fax | 909-868-0206
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Provider Business Mailing Address
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Address Line | 1568 N ORANGE GROVE
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City | POMONA
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State | CA
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Zip | 91767
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Country | US
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Telephone | 909-868-6666
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Fax | 909-868-0206
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | CESAR A. RODRIGUEZ
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Credential | M. D.
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Telephone | 909-868-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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