COLTON VALLEY MEDICAL GROUP NPI 1801991450

NPI Information

COLTON VALLEY MEDICAL GROUP is a general practice in Colton, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee COLTON VALLEY MEDICAL GROUP NPI is 1801991450. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

502 W VALLEY BLVD
COLTON, CA
ZIP 92324
Phone: (909) 825-3202
Fax: (909) 825-9375

The provider's authorized official is Wagian Sun .
The authorized official title is President and has the following contact phone number (909) 825-3202.

The CLIA number assigned to this NPI record is 05D1075489 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/14/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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