| David E Engelhardt MD Inc | |
|
631 N 13th Ave Ste B Upland CA 91786-4964 | |
| (909) 931-3838 | |
| (909) 931-3349 |
| Full Name | David E Engelhardt MD Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 631 N 13th Ave Ste B, Upland, California |
| Authorized Official Name and Position | David Edward Engelhardt (PRESIDENT) |
| Authorized Official Contact | 9099313838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David E Engelhardt MD Inc 631 N 13th Ave Ste B Upland CA 91786-4964 Ph: (909) 931-3838 | David E Engelhardt MD Inc 631 N 13th Ave Ste B Upland CA 91786-4964 Ph: (909) 931-3838 |
| NPI Number | 1295971778 |
|---|---|
| Provider Enumeration Date | 01/05/2009 |
| Last Update Date | 01/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295971778 | NPI | - | NPPES |
| 00G635290 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | G63529 (California) | Primary |
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