Organization
ALLAN G KAVALICH MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAN G KAVALICH M.D. (CEO)
(909) 381-1595
Entity
Organization
Contact information
Practice address
1500 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5111
(909) 381-1595
(909) 381-3291
Mailing address
1500 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5111
(909) 381-1595
(909) 381-3291
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G29326
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G293260
—
CA
Enumeration date
08/26/2010
Last updated
08/26/2010
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