Individual
DR. GEORGE A PONCE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12810 HEACOCK ST, SUITE B201, MORENO VALLEY, CA 92553-2854
(951) 601-2363
(951) 601-2316
Mailing address
1947 CENTURY AVE, RIVERSIDE, CA 92506-4662
(951) 789-9102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A51194
CA
207RC0000X
Cardiovascular Disease Physician
Primary
A51194
CA
Other
Enumeration date
07/06/2006
Last updated
06/19/2008
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