Organization
A.M.PALANCA-CAPISTRANO,M.D.INC.
Active
Parent organization
A.M.PALANCA-CAPISTRANO,M.D.INC
Other names
Capistrano Eye Canter
Organization subpart
Yes
Provider details
NPI number
Legal business name
A.M.PALANCA-CAPISTRANO,M.D.INC
Authorized official
DR. ANGELITA MARQUINEZ PALANCA-CAPISTRANO M.D. (CEO)
(951) 372-9227
Entity
Organization
Contact information
Practice address
13800 HEACOCK ST, SUITE C-110, MORENO VALLEY, CA 92553-3339
(951) 653-3388
Mailing address
19069 VAN BUREN BLVD, 114-219, RIVERSIDE, CA 92508-9169
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A91568
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1585438
—
CA
Enumeration date
10/05/2014
Last updated
10/05/2014
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