Organization
PACIFIC EMPIRE PHYSICAL MEDICINE AND HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALI HALATI MD (DIRECTOR)
(909) 464-9880
Entity
Organization
Contact information
Practice address
4590 RIVERSIDE DR, CHINO, CA 91710-3980
(909) 464-9880
(909) 591-4720
Mailing address
4590 RIVERSIDE DR, CHINO, CA 91710-3980
(909) 464-9880
(909) 591-4720
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A92433
CA
364SF0001X
Family Health Clinical Nurse Specialist
PA18558
CA
Other
Enumeration date
05/17/2015
Last updated
09/21/2015
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