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General NPI Number Information
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NPI Number | 1114531035
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Entity Type | Organization
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Legal Business Name | Q & M PHYSICIAN MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 07/30/2022
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Provider Practice Location Address
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Address Line | 941 KENDALL DR STE C
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4156
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Country | US
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Telephone | 951-316-8406
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Fax |
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Provider Business Mailing Address
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Address Line | 941 KENDALL DR STE C
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4156
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Country | US
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Telephone | 909-726-3200
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Fax | 909-726-1010
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Authorized Official
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Title or Position | OWNER
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Name | QUYEN T DESPAS
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Credential |
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Telephone | 714-397-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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