Organization
SIERRA PEDIATRIC CARDIOLOGY
Active
Organization
SIERRA PEDIATRIC CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH LAI MD (PHYSICIAN/OWNER)
(909) 477-8900
Entity
Organization
Contact information
Practice address
1640 S GROVE AVE, SUITE C, ONTARIO, CA 91761
(909) 477-8900
(909) 277-7894
Mailing address
1640 S GROVE AVE, SUITE C, ONTARIO, CA 91761
(909) 477-8900
(909) 277-7894
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
A112834
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427210079
—
CA
Enumeration date
10/16/2017
Last updated
12/06/2023
Update your record
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