Organization
WEE THRIVE PEDIATRIC THERAPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD FIANO (VP/CFOO)
(949) 872-9288
Entity
Organization
Contact information
Practice address
1031 AVENIDA PICO, SUITE 201, SAN CLEMENTE, CA 92673-6352
(949) 872-9288
Mailing address
1031 AVENIDA PICO, SUITE 201, SAN CLEMENTE, CA 92673-6352
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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