Organization
ULTIMATE MEDICAL PRACTICE A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KANGAH (MEDICAL DIRECTOR/PRESIDENT)
(909) 864-1006
Entity
Organization
Contact information
Practice address
3654 HIGHLAND AVE, SUITE 15, HIGHLAND, CA 92346-2614
(909) 864-1006
(909) 864-1625
Mailing address
3654 HIGHLAND AVE, SUITE 15, HIGHLAND, CA 92346-2614
(909) 864-1006
(909) 864-1625
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A55122
CA
Other
Enumeration date
08/26/2008
Last updated
03/04/2009
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