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Individual

MR. EPHRAIM LITONJUA SANMIGUEL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.C

Contact information

Practice address
2295 S VINEYARD AVE, BLDG A PRIMARY CARE 2ND FLOOR, ONTARIO, CA 91761-7925
(888) 750-0036
(909) 264-2266
Mailing address
2295 S VINEYARD AVE, BLDG A PRIMARY CARE 2ND FLOOR, ONTARIO, CA 91761-7925
(888) 750-0036
(909) 264-2266

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13252
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA13252
MED LIC NUMBER
CA
Enumeration date
04/25/2007
Last updated
11/30/2021
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