SHADOWRIDGE MEDICAL GROUP
Medical Practice at Melrose Dr, Vista, CA

License number
California G045531
Category
Medical Practice
Type
Specialist
Owner
Name: TODD WINE M.D.
Title: PHYSICIAN
Phone: (760) 727-6920
Address
Address
1680 S Melrose Dr STE 105, Vista, CA 92081
National Provider ID: 1639398613
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about SHADOWRIDGE MEDICAL GROUP at bizstanding.com

SHADOWRIDGE MEDICAL GROUP, INC

1680 S Melrose Dr #105, Vista, CA 92081

Status:
Inactive
Registration:
Jan 27, 1998
State ID:
C2037145
Business type:
Articles of Incorporation
President:
Todd Wine President, inactive

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