Healthcare Provider Details

I. General information

NPI: 1427651462
Provider Name (Legal Business Name): SEVEN STAR MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 N SAN JACINTO ST
HEMET CA
92543-3118
US

IV. Provider business mailing address

391 N SAN JACINTO ST
HEMET CA
92543-3118
US

V. Phone/Fax

Practice location:
  • Phone: 515-335-1239
  • Fax: 888-696-2618
Mailing address:
  • Phone: 951-533-5123
  • Fax: 951-929-9786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SANDRA ZARAGOZA
Title or Position: SECRETARY
Credential:
Phone: 951-652-8700