Organization
MED-WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLIS KYLES (OWNER)
(909) 591-2355
Entity
Organization
Contact information
Practice address
5536 PHILADELPHIA ST, SUITE H, CHINO, CA 91710-7533
(909) 591-2355
Mailing address
5536 PHILADELPHIA ST, SUITE H, CHINO, CA 91710-7533
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
46177
CA
Other
Enumeration date
04/11/2007
Last updated
06/26/2008
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