Organization
WESTERN U MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRENA RICH AUTHORIZED OFFICIAL (DIRECTOR OF CLINICAL COMPLIANCE)
(909) 706-3871
Entity
Organization
Contact information
Practice address
5909 SE 92ND AVE, PORTLAND, OR 97266-4642
(909) 469-8534
Mailing address
795 E. SECOND STREET, SUITE 5, POMONA, CA 91766
(909) 469-8332
(909) 706-3785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OR
Other
Enumeration date
05/29/2018
Last updated
11/30/2018
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