Healthcare Provider Details

I. General information

NPI: 1720941453
Provider Name (Legal Business Name): HOSPITAL CLINCIA DEL MAR INTERNATIONAL BILLING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA REVOLUCION, LOPEZ MATEOS
MAZATLAN SINALOA
81240
MX

IV. Provider business mailing address

19300 RINALDI ST UNIT 8392
PORTER RANCH CA
91327-8870
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 888-608-0596
  • Fax: 609-710-5338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOMARIE DEMARCO
Title or Position: CEO
Credential:
Phone: 888-608-0596