Organization
CHINO PEDIATRICS MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA WANG SO M.D. (PRESIDENT)
(951) 333-9667
Entity
Organization
Contact information
Practice address
12584 CENTRAL AVE., CHINO, CA 91710-3507
(909) 287-1800
(909) 287-3300
Mailing address
12584 CENTRAL AVE., CHINO, CA 91710-3507
(909) 287-1800
(909) 287-3300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9397533
—
CA
Enumeration date
07/14/2021
Last updated
07/14/2021
Update your record
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