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Organization
PACIFIC EMPIRE PHYSICAL MEDICINE AND HEALTHCARE INC
Active
Organization
PACIFIC EMPIRE PHYSICAL MEDICINE AND HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALI HALATI MD (DIRECTOR)
(909) 464-9880
Entity
Organization
Contact information
Practice address
4590 RIVERSIDE DR, CHINO, CA 91710-3980
(909) 464-9880
(909) 591-4720
Mailing address
4590 RIVERSIDE DR, CHINO, CA 91710-3980
(909) 464-9880
(909) 591-4720
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A92433
CA
364SF0001X
Family Health Clinical Nurse Specialist
PA18558
CA
Other
Enumeration date
05/17/2015
Last updated
09/21/2015
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