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Organization
RANCHO INDUSTRIAL MEDICAL GROUP, INC.
Active
Organization
RANCHO INDUSTRIAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDO E ANGUIZOLA M.D. (PRESIDENT)
(909) 350-7208
Entity
Organization
Contact information
Practice address
14384 SLOVER AVE, FONTANA, CA 92337-7122
(909) 350-7208
(909) 350-7209
Mailing address
14384 SLOVER AVE, FONTANA, CA 92337-7122
(909) 350-7208
(909) 350-7209
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
27592
CA
174400000X
Specialist
Primary
A37952
CA
174400000X
Specialist
G39074
CA
363AM0700X
Medical Physician Assistant
18783
CA
363AM0700X
Medical Physician Assistant
20771
CA
Other
Enumeration date
03/02/2008
Last updated
03/02/2008
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