Organization
BRIAN LEBERTHON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY MCGOWEN (MANAGER)
(626) 338-9560
Entity
Organization
Contact information
Practice address
1135 S SUNSET AVE, 207, WEST COVINA, CA 91790-3937
(626) 338-9560
Mailing address
1135 S SUNSET AVE, 207, WEST COVINA, CA 91790-3937
(626) 338-9560
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
470405
CA
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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