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General NPI Number Information
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NPI Number | 1083731798
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Entity Type | Organization
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Legal Business Name | IMPERIAL MEDICAL MANAGEMENR, INC.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 27297 LINDELL RD
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City | LAKE ELSINORE
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State | CA
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Zip | 92532-7341
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Country | US
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Telephone | 951-674-2424
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Fax | 951-674-5656
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Provider Business Mailing Address
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Address Line | 18285 COLLIER AVENUE SUITE 201
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City | LAKE ELSINORE
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State | CA
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Zip | 92530
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Country | US
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Telephone | 951-674-2424
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Fax | 951-674-5656
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STANLEY IRENEUSZ SZYMCZYK
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Credential |
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Telephone | 951-674-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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