Healthcare Provider Details

I. General information

NPI: 1134321144
Provider Name (Legal Business Name): SUMMIT MEDICAL MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7040 TRASK AVE
WESTMINSTER CA
92683-2622
US

IV. Provider business mailing address

7040 TRASK AVE
WESTMINSTER CA
92683-2622
US

V. Phone/Fax

Practice location:
  • Phone: 714-901-4399
  • Fax: 714-890-6012
Mailing address:
  • Phone: 714-901-4399
  • Fax: 714-890-6012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 3471
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT11796
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberPT11796
License Number StateCA

VIII. Authorized Official

Name: FARIMA SHAHAMATI
Title or Position: OFFICER
Credential: PT.,OMD
Phone: 310-203-9292