| California State Polytechnic University | |
|
3801 W Temple Ave Pomona CA 91768-2557 | |
| (909) 869-4000 | |
| Not Available |
| Full Name | California State Polytechnic University |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 3801 W Temple Ave, Pomona, California |
| Authorized Official Name and Position | Kay Vierra (INTERIM DIRECTOR) |
| Authorized Official Contact | 9098692760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| California State Polytechnic University 3801 W Temple Ave Pomona CA 91768-2557 Ph: (909) 869-4000 | California State Polytechnic University 3801 W Temple Ave Pomona CA 91768-2557 Ph: (909) 869-4000 |
| NPI Number | 1063694479 |
|---|---|
| Provider Enumeration Date | 11/28/2007 |
| Last Update Date | 11/28/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063694479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 306630 (California) | Primary |
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