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Organization

JOHN B. SLAYBACK, M.D., INC.

Active
Parent organization
JOHN B. SLAYBACK, M.D., INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
JOHN B. SLAYBACK, M.D., INC.
Authorized official
MR. JOHN B. SLAYBACK M.D. (PRESIDENT)
(909) 793-3760
Entity
Organization

Contact information

Practice address
355 TERRACINA BLVD, REDLANDS, CA 92373-4819
(909) 793-3760
(909) 335-8625
Mailing address
355 TERRACINA BLVD, REDLANDS, CA 92373-4819
(909) 793-3760
(909) 335-8625

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A21757
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245302223
INDIVIDUAL NPI
CA
Enumeration date
10/19/2007
Last updated
10/19/2007
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