Organization
DINE MONTE NIDO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF RADANT (CHIEF OPERATING OFFICER)
(310) 589-8999
Entity
Organization
Contact information
Practice address
237 EAST LANCASTER AVE, DEVON, PA 19333
(215) 350-5526
Mailing address
27162 SEA VISTA DR, MALIBU, CA 90265-4437
(310) 457-9958
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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