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Organization
RANCHO CUCAMONGA PERPETUAL HELP MEDICAL CORPORATION
Active
Organization
RANCHO CUCAMONGA PERPETUAL HELP MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLORENCIA T TAMPOYA MD (PHYSICIAN OWNER)
(909) 466-6410
Entity
Organization
Contact information
Practice address
8112 MILLIKEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-7472
(909) 466-6410
(909) 466-5667
Mailing address
8112 MILLIKEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-7472
(909) 466-6410
(909) 466-5667
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A47994
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0101410
—
CA
01
—
ZZZ07974Z
BLUE SHIELD #
CA
Enumeration date
02/03/2006
Last updated
11/21/2016
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