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General NPI Number Information
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NPI Number | 1982987095
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Entity Type | Organization
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Legal Business Name | APEX PEDIATRICS INC
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Dates
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Enumeration Date | 09/25/2011
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 399 E HIGHLAND AVE STE 329
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-3861
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Country | US
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Telephone | 909-886-5200
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Fax | 909-886-0333
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Provider Business Mailing Address
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Address Line | 399 E HIGHLAND AVE STE 329
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-3861
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Country | US
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Telephone | 909-886-5200
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Fax | 909-886-0333
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Authorized Official
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Title or Position | MANAGER
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Name | MR. STEVE STANLEY WILDISH
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Credential |
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Telephone | 951-378-3605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 00A4252620
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License Number State | CA
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