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General NPI Number Information
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NPI Number | 1063015154
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Entity Type | Organization
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Legal Business Name | SEVEN STAR MEDICAL GROUP INC.
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1225 E LATHAM AVE STE A
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City | HEMET
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State | CA
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Zip | 92543-4423
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Country | US
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Telephone | 951-766-0374
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Fax | 951-766-0601
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Provider Business Mailing Address
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Address Line | 41889 FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92544-5042
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Country | US
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Telephone | 951-595-4596
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Fax | 951-595-4597
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MERRIANNA ADAME
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Credential |
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Telephone | 951-652-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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