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General NPI Number Information
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NPI Number | 1487758132
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Entity Type | Organization
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Legal Business Name | ALBERT RIDLOVSKY MD, INC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 8112 MILLIKEN AVE SUITE 103-2
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7471
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Country | US
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Telephone | 909-481-0752
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Fax | 909-481-0804
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Provider Business Mailing Address
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Address Line | 8112 MILLIKEN AVE SUITE 103-2
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7471
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Country | US
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Telephone | 909-481-0752
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Fax | 909-481-0804
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Authorized Official
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Title or Position | INTERNAL MEDICINE
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Name | ALBERT RIDLOVSKI
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Credential | M.D.
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Telephone | 909-481-0752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | A88847
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License Number State | CA
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