Organization
JOSE DE LA LLANA M.D.. INC
Active
Other names
Su Clinica Medica Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL PULGARIN (MANAGER)
(909) 886-7576
Entity
Organization
Contact information
Practice address
850 W HIGHLAND AVE, SUITE A, SAN BERNARDINO, CA 92405-3855
(909) 886-7576
(909) 882-4921
Mailing address
850 W HIGHLAND AVE, SUITE A, SAN BERNARDINO, CA 92405-3855
(909) 886-7576
(909) 882-4921
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A101657
CA
Other
Enumeration date
06/13/2016
Last updated
06/09/2024
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