Organization
POMONA VALLEY PODIATRY GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN FREDERICK ONEILL DPM (PRESIDENT)
(909) 622-4501
Entity
Organization
Contact information
Practice address
1212 N PARK AVE, POMONA, CA 91768-3029
(909) 622-4501
(909) 632-1729
Mailing address
1212 N PARK AVE, POMONA, CA 91768-3029
(909) 622-4501
(909) 632-1729
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E302900
—
CA
Enumeration date
07/30/2006
Last updated
05/16/2013
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