Organization
BORROMEO III MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY BRAGANZA (CREDENTIALING MANAGER)
(562) 414-4222
Entity
Organization
Contact information
Practice address
3218 E HOLT AVE STE 200, WEST COVINA, CA 91791-2310
(562) 414-4222
(562) 865-0444
Mailing address
3218 E HOLT AVE STE 200, WEST COVINA, CA 91791-2310
(562) 414-4222
(562) 865-0444
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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