Pediatric Adolescent Clinic
NPI #1164859385 in Upland, California
Provider Information
- NPI Number
- 1164859385
- Entity Type
- Organization
- Organization Name
- Pediatric Adolescent Clinic
- Primary Specialty
- Pediatrics - Adolescent Medicine
- Enumeration Date
- Oct 2, 2013
- Last Updated
- Oct 2, 2013
Practice Location
- Address
- 1214 ADRIANA WAY
- City
- Upland
- State
- California
- ZIP Code
- 91784-1742
- Phone
- (909) 946-4155
Authorized Official
- Name
- DR. RAOUF AZIZ IBRAHIM I, M.D.
- Title
- PEDIATRICIAN
- Phone
- (909) 946-4175
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics - Adolescent Medicine — Adolescent Medicine |
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