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General NPI Number Information
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NPI Number | 1851301576
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Entity Type | Organization
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Legal Business Name | POMONA VALLEY CARDIAC SURGERY
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 160 E ARTESIA ST SUITE 355
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City | POMONA
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State | CA
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Zip | 91767-2900
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Country | US
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Telephone | 909-865-1161
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Fax | 909-865-1737
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Provider Business Mailing Address
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Address Line | 160 E ARTESIA ST SUITE 355
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City | POMONA
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State | CA
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Zip | 91767-2900
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Country | US
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Telephone | 909-865-1161
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Fax | 909-865-1737
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. RAMONA NELL RUE
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Credential |
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Telephone | 909-865-1161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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