Organization
PACIFIC WEST SPECIALTIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ROTAN (C.F.O.)
(909) 335-8649
Entity
Organization
Contact information
Practice address
101 E REDLANDS BLVD STE 212, REDLANDS, CA 92373-4724
(909) 335-8649
(909) 335-1994
Mailing address
PO BOX 11525, SAN BERNARDINO, CA 92423-1525
(909) 335-8649
(909) 335-1994
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
07/12/2006
Last updated
08/22/2020
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