Organization
COLTON VALLEY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAGIAN SUN MD (PRESIDENT)
(909) 825-3202
Entity
Organization
Contact information
Practice address
502 W VALLEY BLVD, COLTON, CA 92324
(909) 825-3202
(909) 825-9375
Mailing address
502 W VALLEY BLVD, COLTON, CA 92324
(909) 825-3202
(909) 825-9375
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A23744
CA
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A237440
—
CA
05
—
GR0041960
—
CA
Enumeration date
09/14/2006
Last updated
09/11/2025
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