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Organization
GREEN RIVER MEDICAL & AESTHETIC CENTRE INC.
Active
Organization
GREEN RIVER MEDICAL & AESTHETIC CENTRE INC.
Active
Other names
Family & Aesthetic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD B MANTELL M.D. (C.O.O)
(951) 735-5570
Entity
Organization
Contact information
Practice address
2791 GREEN RIVER #103, CORONA, CA 92882-7426
(951) 735-5570
(951) 735-5572
Mailing address
PO BOX 18706, ANAHEIM, CA 92817-8706
(951) 735-5570
(951) 735-5572
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
NPF20032
CA
Other
Enumeration date
06/11/2012
Last updated
08/22/2014
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