Healthcare Provider Details

I. General information

NPI: 1548171515
Provider Name (Legal Business Name): SILVER SUMMIT MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7206 N MILBURN AVE STE 103
FRESNO CA
93722-8450
US

IV. Provider business mailing address

PO BOX 748792
LOS ANGELES CA
90074-3529
US

V. Phone/Fax

Practice location:
  • Phone: 661-324-4100
  • Fax: 661-324-4600
Mailing address:
  • Phone: 661-324-4100
  • Fax: 661-324-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DULCE LOMELI
Title or Position: AO
Credential:
Phone: 661-324-4100