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1134398332
BODY 101
GLENDORA, CA
NPI
1134398332
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Entity Type
Organization
Authorized Contact
STEPHANIE RADE
D.O
909-399-0040
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: CA 20A8673)
Enumeration Date
2008-02-21
Last Update Date
2008-02-21
Business Address
BODY 101
1822A E ROUTE 66 # 279
GLENDORA, CA 91740-3868
Phone number: 909-399-0040
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Mailing Address
BODY 101
PO BOX 486
MONROVIA, CA 91017-0486
Phone number: 909-399-0040
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