Organization
INDEPENDENT PHLEBOTOMY PROVIDER GROUP L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHEELAH ZASKE CPT (OWNER/DIRECTOR)
(909) 482-4620
Entity
Organization
Contact information
Practice address
1420 N CLAREMONT BLVD, SUITE #212B, CLAREMONT, CA 91711-3528
(909) 482-4620
(909) 482-4623
Mailing address
1420 N CLAREMONT BLVD, SUITE #212B, CLAREMONT, CA 91711-3528
(909) 482-4620
(909) 482-4623
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CPT19077
CA
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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