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Organization
GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP, A PROFESSIONAL
Active
Organization
GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP, A PROFESSIONAL
Active
Other names
Gastroenterology Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO IBARRA MD (AUTHORIZED OFFICIAL)
(626) 872-6261
Entity
Organization
Contact information
Practice address
880 S ATLANTIC BLVD, SUITE G 10, MONTEREY PARK, CA 91754-4700
(626) 872-6261
(626) 872-1948
Mailing address
880 S ATLANTIC BLVD, #G 10, MONTEREY PARK, CA 91754-4700
(626) 872-6261
(626) 872-1948
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/08/2007
Last updated
01/15/2020
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