Healthcare Provider Details

I. General information

NPI: 1982933594
Provider Name (Legal Business Name): ZOOMMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8237 ROCHESTER AVE BLDG 10 SUITE 10-101
RANCHO CUCAMONGA CA
91730-0716
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 909-992-3238
  • Fax: 909-495-1647
Mailing address:
  • Phone: 909-992-3238
  • Fax: 909-495-1647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG75148
License Number StateCA

VIII. Authorized Official

Name: JEFFREY P QUAM
Title or Position: PRESIDENT
Credential: MD
Phone: 909-992-3238