Organization
PARK SIERRA MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANIL DONALD MALL MD (OWNER)
(909) 533-4443
Entity
Organization
Contact information
Practice address
1023 S MOUNT VERNON AVE STE A, COLTON, CA 92324-4202
(909) 533-4443
(909) 533-4483
Mailing address
1023 S MOUNT VERNON AVE STE A, COLTON, CA 92324-4202
(909) 533-4443
(909) 533-4483
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2007
Last updated
09/09/2021
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