Provider Demographics
NPI:1265750533
Name:WESTERN UNIVERSITY OF HEALTH SCIENCES
Entity type:Organization
Organization Name:WESTERN UNIVERSITY OF HEALTH SCIENCES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PADOONGPATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-865-2565
Mailing Address - Street 1:795 E. SECOND STREET
Mailing Address - Street 2:SUITE 8
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2020
Mailing Address - Country:US
Mailing Address - Phone:909-706-3911
Mailing Address - Fax:909-469-8650
Practice Address - Street 1:795 E. SECOND STREET
Practice Address - Street 2:SUITE 8
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2020
Practice Address - Country:US
Practice Address - Phone:909-706-3911
Practice Address - Fax:909-469-8650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTERN UNIVERSITY OF HEALTH SCIENCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-12
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental