Organization
MARTHA S CRISOSTOMO
Active
Other names
ultimate results
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA S CRISOSTOMO (OWNER)
(909) 684-2022
Entity
Organization
Contact information
Practice address
1000 W 4TH ST, SUITE 375, ONTARIO, CA 91762-1811
(909) 684-2022
Mailing address
1000 W 4TH ST, SUITE 375, ONTARIO, CA 91762-1811
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D1090838
CA
Other
Enumeration date
11/10/2008
Last updated
07/31/2009
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