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Organization

BODY 101

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE RADE D.O (D.O)
(909) 399-0040
Entity
Organization

Contact information

Practice address
1822A E ROUTE 66 # 279, GLENDORA, CA 91740-3868
(909) 399-0040
Mailing address
PO BOX 486, MONROVIA, CA 91017-0486
(909) 399-0040

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A8673
CA

Other

Enumeration date
02/21/2008
Last updated
02/21/2008
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