Organization Name: | CARRILLO, URBINA & GARCIA, INC |
NPI Number: | 1255527461 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARVIN URBINA (SECRETARY) |
Mailing Address: | 16980 Foothill Blvd Ste E Fontana |
State: | CA US |
Postal Code: | 923353569 |
Phone Number: | 9094340616 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2007 |
NPI Last Update Date: | 09/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A71133 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |