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NPI Code Detail

MEDICARE: HA SARREONG CILLPAME DPT

MEDICARE: HA SARREONG CILLPAME DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician42173CA

General Provider Information

NPI Number : 1780549311
Entity Type Code : Individual
Provider Name (Legal Business Name) : HA SARREONG CILLPAME DPT
Provider Business Mailing Address
First Line : 3475 E PINE RIDGE LOOP
Second Line :
City : ONTARIO
State : CA
Zip : 91761-3826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9961 SIERRA AVE
Second Line :
City : FONTANA
State : CA
Zip : 92335-6720
Country : US
Telephone Number : 833-574-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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Directions to “ HA SARREONG CILLPAME DPT” Practice Location

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