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General NPI Number Information
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NPI Number | 1104037092
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Entity Type | Organization
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Legal Business Name | MARIA FLORA G. TRIMOR-TAMORIA MEDICAL CLINIC, INC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 2240 E PLAZA BLVD STE A
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City | NATIONAL CITY
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State | CA
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Zip | 91950-5165
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Country | US
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Telephone | 619-267-5884
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Fax | 619-267-6073
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Provider Business Mailing Address
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Address Line | 2240 E PLAZA BLVD STE A
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City | NATIONAL CITY
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State | CA
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Zip | 91950-5165
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Country | US
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Telephone | 619-267-5884
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Fax | 619-267-6073
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA FLORA GALLARDO TRIMOR-TAMORIA
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Credential | M.D.
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Telephone | 619-267-5884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A55589
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License Number State | CA
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