Organization
CLINICA DEL PUEBLO MEDICAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM N RATNAYAKE MD (DIRECTOR)
(661) 377-3777
Entity
Organization
Contact information
Practice address
10200 MAIN ST STE B, LAMONT, CA 93241-1700
(661) 845-1788
(661) 845-1791
Mailing address
10200 MAIN ST STE B, LAMONT, CA 93241-1700
(661) 845-1788
(661) 845-1791
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A056363
CA
Other
Enumeration date
11/06/2010
Last updated
11/06/2010
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