Healthcare Provider Details

I. General information

NPI: 1376779058
Provider Name (Legal Business Name): ZOOMMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 BASELINE RD SUITE 140
RANCHO CUCAMONGA CA
91730-1350
US

IV. Provider business mailing address

7201 HAVEN AVE SUITE E222
RANCHO CUCAMONGA CA
91701-6065
US

V. Phone/Fax

Practice location:
  • Phone: 909-246-8447
  • Fax: 909-614-7168
Mailing address:
  • Phone: 909-246-8447
  • Fax: 909-614-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA104279
License Number StateCA

VIII. Authorized Official

Name: MELINA T DOAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 909-246-8447