Organization
ACE MEDICAL GROUP A PROFESSIONAL CORPORATION
Active
Other names
Pine Avenue Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DIMOWO MD (PRESIDENT)
(909) 287-7474
Entity
Organization
Contact information
Practice address
5857 PINE AVE, CHINO HILLS, CA 91709-6536
(909) 287-7474
(909) 287-7470
Mailing address
5857 PINE AVE, CHINO HILLS, CA 91709-6536
(909) 287-7474
(909) 287-7470
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A52501
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A52501
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
01/20/2011
Last updated
01/20/2011
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