Premier Ent A Medical Corp
Specialist in Redlands, CA. Organization (NPI-2).
NPI number1992903686
StatusActive
Last updated in NPPESDec 1, 2008
Details
- NPI
- 1992903686
- Entity type
- Organization (NPI-2)
- Legal business name
- Premier Ent A Medical Corp
- Organization subpart
- No
- Enumeration date
- Jul 5, 2007
- Last updated
- Dec 1, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | A50970 | CA | Yes |
Practice location
255 Terracina BlvdSuite 201
Redlands, CA 92373-4870
Phone 909-793-2500 · Fax 951-845-2181
Mailing address
255 Terracina BlvdSuite 201
Redlands, CA 92373-4870
Phone 909-793-2500 · Fax 951-845-2181
Authorized official
Sharen Knudsen Jeffries
Owner
9097932500
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