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Organization
JOSE DE LA LLANA M.D.. INC
Active
Organization
JOSE DE LA LLANA M.D.. INC
Active
Other names
Su Clinica Medica Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL PULGARIN (MANAGER)
(909) 886-7576
Entity
Organization
Contact information
Practice address
850 W HIGHLAND AVE, SUITE A, SAN BERNARDINO, CA 92405-3855
(909) 886-7576
(909) 882-4921
Mailing address
850 W HIGHLAND AVE, SUITE A, SAN BERNARDINO, CA 92405-3855
(909) 886-7576
(909) 882-4921
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A101657
CA
Other
Enumeration date
06/13/2016
Last updated
06/09/2024
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