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Organization
MOUNTAIN EMPIRE USD
Active
Organization
MOUNTAIN EMPIRE USD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK JUDD (SUPERINTENDENT)
(619) 473-9022
Entity
Organization
Contact information
Practice address
3291 BUCKMAN SPRINGS RD, PINE VALLEY, CA 91962-4003
(619) 473-9022
Mailing address
3291 BUCKMAN SPRINGS RD, PINE VALLEY, CA 91962-4003
(619) 473-9022
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SS3768213
MEDI-CAL
—
Enumeration date
12/26/2007
Last updated
12/26/2007
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