Healthcare Provider Details

I. General information

NPI: 1982871455
Provider Name (Legal Business Name): SENIOR FIRST MEDICAL CLINIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 W FLORIDA AVE SUITE H
HEMET CA
92545-5279
US

IV. Provider business mailing address

41885 E FLORIDA AVE
HEMET CA
92544-5042
US

V. Phone/Fax

Practice location:
  • Phone: 951-652-0522
  • Fax: 951-652-7422
Mailing address:
  • Phone: 951-791-1111
  • Fax: 951-925-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROSIE GARCIA
Title or Position: MANAGER
Credential:
Phone: 951-791-1111