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Organization
ARROWHEAD COMMUNITY SURGICAL MEDICAL GROUP, INC.
Active
Organization
ARROWHEAD COMMUNITY SURGICAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APPANAGARI GNANADEV MD. (PRESIDENT)
(909) 580-6210
Entity
Organization
Contact information
Practice address
400 N PEPPER AVE, SURGERY DEPARTMENT, COLTON, CA 92324-1801
(909) 580-6210
(909) 580-1363
Mailing address
PO BOX 670, REDLANDS, CA 92373-0221
(909) 580-6210
(909) 580-1363
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
51201
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00SP18300
—
CA
05
—
GR0079700
—
CA
Enumeration date
01/08/2007
Last updated
08/22/2020
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