Organization
PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL FUCHIGAMI-BOST, RN RN (COO)
(951) 252-8588
Entity
Organization
Contact information
Practice address
900 N HERITAGE DR, BLDG. A, RIDGECREST, CA 93555-5536
(951) 252-8588
(951) 252-8589
Mailing address
27699 JEFFERSON AVE, SUITE 300, TEMECULA, CA 92590-2661
(951) 252-8588
(951) 252-8589
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
0900009973
CA
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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