Organization · NPI-2

Alav Medical Corporation

Family Medicine · Fontana, CA

NPI number1104016468
StatusActive
Last updated in NPPESMar 30, 2018

Details

NPI
1104016468
Entity type
Organization (NPI-2)
Legal business name
Alav Medical Corporation
Organization subpart
No
Enumeration date
Aug 1, 2007
Last updated
Mar 30, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineA74033CAYes

Practice location

16465 Sierra Lakes Pkwy
Ste 220
Fontana, CA 92336-1242

Phone 909-434-1123 · Fax 909-261-8082

Mailing address

16465 Sierra Lakes Pkwy Ste 200
Fontana, CA 92336-1242

Phone 909-429-2404 · Fax 909-261-8082

Authorized official

Faramarz Alav
President
9092618082

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