Individual
MR. SIDNEY UNTAL SUAREZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 E GILBERT ST, SAN BERNARDINO, CA 92415-0928
(909) 387-7200
Mailing address
820 E GILBERT ST, SAN BERNARDINO, CA 92415-0928
(909) 387-7200
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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