National Provider Identifier Database

PEDIATRIC ADOLESCENT CLINIC
Adolescent Medicine

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.


Contact Information

PEDIATRIC ADOLESCENT CLINIC
1214 ADRIANA WAY
UPLAND, CA91784-1742
Phone: 909-946-4155
Fax: 909-949-8836
Website:
Specialty Taxonomy Code
* Adolescent Medicine 2080A0000X

* Indicates primary specialty

NPI Profile & details for PEDIATRIC ADOLESCENT CLINIC

NPI Number 1164859385
Legal business name
LBN
PEDIATRIC ADOLESCENT CLINIC
Authorized official RAOUF IBRAHIM - (PEDIATRICIAN)
Entity Organization
Organization subpart No
Enumeration date 10/02/2013
Last updated 10/02/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: AFE33327

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PEDIATRIC ADOLESCENT CLINIC

There are currently no reviews for PEDIATRIC ADOLESCENT CLINIC


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