Organization
MT. SAN ANTONIO COLLEGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA SAMPLES RN (DIRECTOR, STUDENT HEALTH SERVICES)
(909) 594-5611
Entity
Organization
Contact information
Practice address
1100 N GRAND AVE, 67B, WALNUT, CA 91789-1341
(909) 594-5611
(909) 468-3997
Mailing address
1100 N GRAND AVE, 67B, WALNUT, CA 91789-1341
(909) 591-5611
(909) 468-3997
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2008
Last updated
01/04/2008
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