| Michelle Dilley Revier, MD | |
|
9961 Sierra Ave, Fontana, CA 92335-6720 | |
| (909) 427-5000 | |
| Not Available |
| Full Name | Michelle Dilley Revier |
|---|---|
| Gender | Female |
| Speciality | Allergy & Immunology - Allergy |
| Location | 9961 Sierra Ave, Fontana, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437656915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207KA0200X | Allergy & Immunology - Allergy | A165333 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Dilley Revier, MD 3020 Childrens Way # Mc5124, San Diego, CA 92123-4223 Ph: () - | Michelle Dilley Revier, MD 9961 Sierra Ave, Fontana, CA 92335-6720 Ph: (909) 427-5000 |
Sandy Y Jung-wu, MD Allergy & Immunology Medicare: Medicare Enrolled Practice Location: 9985 Sierra Ave, Fontana, CA 92335 Phone: 909-427-6498 | |
Pauline B. Tsai, MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Michael W. Chien, MD Allergy & Immunology Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 |