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Organization

CENTRELAKE MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANIA CEJA (MANAGER)
(909) 242-7300
Entity
Organization

Contact information

Practice address
5562 PHILADELPHIA ST STE 100, CHINO, CA 91710-2482
(909) 242-7300
(909) 784-3760
Mailing address
3115 E GUASTI RD, ONTARIO, CA 91761-7853
(909) 242-7300
(909) 784-3760

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Enumeration date
05/31/2019
Last updated
05/24/2021
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