Individual
GREGORY THOMAS HAVLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-5000
Mailing address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-5000
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A113756
CA
Other
Enumeration date
06/25/2009
Last updated
12/02/2021
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