Organization
LANTERMAN DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. H. NGUYEN MD (MEDICAL DIRECTOR)
(909) 595-1221
Entity
Organization
Contact information
Practice address
3530 POMONA BLVD, POMONA, CA 91768-3238
(909) 595-1221
Mailing address
2224 SHADY HILLS DR, DIAMOND BAR, CA 91765-2817
(909) 519-9531
(909) 861-4110
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
578663 BRN
CA
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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