Healthcare Provider Details

I. General information

NPI: 1396778742
Provider Name (Legal Business Name): POMA MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 S FAIR OAKS AVE
PASADENA CA
91105-2621
US

IV. Provider business mailing address

PO BOX 80648
SAN MARINO CA
91118-8648
US

V. Phone/Fax

Practice location:
  • Phone: 626-403-9000
  • Fax:
Mailing address:
  • Phone: 626-403-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA SULINDRO
Title or Position: PRESIDENT
Credential:
Phone: 626-403-9000