Provider Demographics
NPI:1376843367
Name:UPLAND NEW HEALTH CENTER
Entity Type:Organization
Organization Name:UPLAND NEW HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WEIHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, PHD
Authorized Official - Phone:909-920-5817
Mailing Address - Street 1:555 E FOOTHILL BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3994
Mailing Address - Country:US
Mailing Address - Phone:909-920-5817
Mailing Address - Fax:909-243-1186
Practice Address - Street 1:555 E FOOTHILL BLVD STE 9
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3994
Practice Address - Country:US
Practice Address - Phone:909-920-5817
Practice Address - Fax:909-243-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11056302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization