JACK B KISTLER MD INC
Ambulatory Health at Brockton Ave, Riverside, CA

License number
California C26186
Category
Ambulatory Health
Type
Primary Care
Owner
Name: MR. JACK BARTLETT KISTLER M.D.
Title: PRESIDENT
Phone: (951) 682-6263
Address
Address
6900 Brockton Ave STE 11, Riverside, CA 92506
National Provider ID: 1457676249
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JACK B. KISTLER, M.D., INC

La Mirada, CA  -  Riverside, CA

Industry:
Medical Doctor's Office
Registration:
Aug 25, 1980
Phone:
(951) 682-6263 (Phone)
Addresses:
16800 Vly Vw Ave, La Mirada, CA 90638 (Physical)
6900 Brockton Ave, Riverside, CA 92506
State ID:
C1000792
Business type:
Articles of Incorporation
President:
Jack B. Kistler (President)

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