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General NPI Number Information
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NPI Number | 1144195884
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Entity Type | Organization
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Legal Business Name | MODERM MEDICAL SOLUTIONS CA INC.
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 2263 FINCH CIRCLE
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City | SAN JACINTO
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State | CA
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Zip | 92582
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Country | US
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Telephone | 888-211-1498
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Fax | 888-211-4677
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Provider Business Mailing Address
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Address Line | 3350 SHELBY ST STE 200
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City | ONTARIO
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State | CA
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Zip | 91764-5556
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Country | US
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Telephone | 888-211-1498
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Fax | 888-211-4677
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Authorized Official
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Title or Position | OWNER/CEO
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Name | TAMARA SUE PIPPIN
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Credential | APRN-FNP
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Telephone | 760-525-5894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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