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Organization
CUCAMONGA VALLEY MEDICAL GROUP, INC.
Active
Organization
CUCAMONGA VALLEY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE NELSON SMART D.O. (PRESIDENT)
(909) 429-2864
Entity
Organization
Contact information
Practice address
16465 SIERRA LAKES PARKWAY, #300, FONTANA, CA 92336
(909) 429-2864
(909) 429-2868
Mailing address
16465 SIERRA LAKES PARKWAY, #300, FONTANA, CA 92336
(909) 429-2864
(909) 429-2868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
858582
ME
Other
Enumeration date
06/29/2006
Last updated
04/29/2013
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