Organization
ACE GASTROENTEROLOGY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KUMAR BALASUBRAMANIAM MD (OWNER)
(909) 851-7676
Entity
Organization
Contact information
Practice address
2006 N. RIVERSIDE AVENUE, RIALTO, CA 92377
(909) 881-3032
Mailing address
1559 MARION RD, REDLANDS, CA 92374-6332
(909) 881-3032
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A447160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A447160
—
CA
Enumeration date
01/03/2014
Last updated
01/03/2014
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