Individual
MR. MICHAEL PONCO FONTELERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4049 FIRST ST, SUITE 134, LIVERMORE, CA 94551-5379
(925) 249-1400
(925) 249-1414
Mailing address
PO BOX 2111, LIVERMORE, CA 94551-2111
(925) 249-1400
(925) 249-1414
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
44039
CA
Other
Enumeration date
07/27/2006
Last updated
05/01/2008
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