Healthcare Provider Details

I. General information

NPI: 1477476265
Provider Name (Legal Business Name): SYMBA CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16902 1ST ST
VICTORVILLE CA
92395-3111
US

IV. Provider business mailing address

16519 VICTOR ST STE 424
VICTORVILLE CA
92395-3935
US

V. Phone/Fax

Practice location:
  • Phone: 760-585-1228
  • Fax:
Mailing address:
  • Phone: 442-242-1809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAWN ROBERT SMITH
Title or Position: CEO
Credential: PHARMD
Phone: 717-884-2108