Organization
CALIFORNIA STATE POLYTECHNIC UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAY VIERRA (INTERIM DIRECTOR)
(909) 869-2760
Entity
Organization
Contact information
Practice address
3801 W TEMPLE AVE, POMONA, CA 91768-2557
(909) 869-4000
Mailing address
3801 W TEMPLE AVE, POMONA, CA 91768-2557
(909) 869-4000
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
306630
CA
Other
Enumeration date
11/28/2007
Last updated
11/28/2007
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