Organization
452 ASTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA HIGGINS (SENIOR ART)
(951) 655-2751
Entity
Organization
Contact information
Practice address
1444 CHARDONNAY PL, SAN JACINTO, CA 92582-4267
(951) 553-6962
Mailing address
1444 CHARDONNAY PL, SAN JACINTO, CA 92582-4267
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
815107
CA
Other
Enumeration date
01/26/2014
Last updated
01/26/2014
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