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General NPI Number Information
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NPI Number | 1083362297
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Entity Type | Organization
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Legal Business Name | SYMBA CENTER
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 16902 1ST ST
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City | VICTORVILLE
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State | CA
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Zip | 92395-3111
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Country | US
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Telephone | 760-515-2464
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Fax |
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Provider Business Mailing Address
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Address Line | 16519 VICTOR ST STE 424
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City | VICTORVILLE
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State | CA
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Zip | 92395-3935
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Country | US
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Telephone | 760-515-2464
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. SHAWN SMITH
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Credential | PHARMD
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Telephone | 760-515-2464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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