Body 101

NPI #1134398332 in Glendora, California

Provider Information

NPI Number: 1134398332
Entity Type: Organization
Organization Name: Body 101
Primary Specialty: Internal Medicine
Enumeration Date: Feb 21, 2008
Last Updated: Feb 21, 2008

Practice Location

Address: 1822A E ROUTE 66 # 279
City: Glendora
State: California
ZIP Code: 91740-3868
Phone: (909) 399-0040

Authorized Official

Name: STEPHANIE RADE, D.O
Title: D.O
Phone: (909) 399-0040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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