Organization
SAN GABRIEL VALLEY PERINATAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARMEN O AVILA (OFFICE MANAGER)
(626) 337-4425
Entity
Organization
Contact information
Practice address
1135 S SUNSET AVE, STE 402, WEST COVINA, CA 91790-3938
(626) 337-4425
(626) 337-4606
Mailing address
1135 S SUNSET AVE, STE 402, WEST COVINA, CA 91790-3938
(626) 337-4425
(626) 337-4606
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A507640
—
CA
05
—
00G794030
—
CA
01
—
G71304
BRENDA ROSS, M.D.
CA
Enumeration date
05/12/2006
Last updated
06/20/2018
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