Healthcare Provider Details

I. General information

NPI: 1669841995
Provider Name (Legal Business Name): INJURY CENTER MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 E REDLANDS BLVD SUITE C
SAN BERNARDINO CA
92408-3718
US

IV. Provider business mailing address

432 E. REDLANDS BLVD SUITE C
SAN BERNARDINO CA
92408
US

V. Phone/Fax

Practice location:
  • Phone: 909-571-6235
  • Fax: 909-575-3712
Mailing address:
  • Phone: 909-571-6235
  • Fax: 909-575-3712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW JARMINSKI
Title or Position: PRESIDENT
Credential: MD
Phone: 909-571-6235