Organization
SO CAL MIWLS INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN YADEGAR MD (PRESIDENT)
(310) 995-9600
Entity
Organization
Contact information
Practice address
627 W AVENUE Q STE A, PALMDALE, CA 93551-3891
(661) 723-7833
(877) 723-1502
Mailing address
627 W AVENUE Q STE A, PALMDALE, CA 93551-3891
(661) 723-7833
(877) 723-1502
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A87209
CA
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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