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Organization

HEALTHSOURCE MEDICAL NETWORK, INC.

Active
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Organization

HEALTHSOURCE MEDICAL NETWORK, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ARNOLD SANVICENTE (PRESIDENT)
(909) 971-9334
Entity
Organization

Contact information

Practice address
11190 WARNER AVE STE 302, FOUNTAIN VALLEY, CA 92708-4047
(714) 241-8000
(714) 241-8003
Mailing address
417 W ALLEN AVE STE 18, SAN DIMAS, CA 91773-4709
(909) 971-9334
(909) 575-3573

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—

Other

Enumeration date
02/12/2014
Last updated
02/12/2014
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