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General NPI Number Information
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NPI Number | 1154742229
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Entity Type | Organization
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Legal Business Name | IM-FSR INC.
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 17416 E. PARK
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City | CHINO HILLS
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State | CA
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Zip | 91709
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Country | US
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Telephone | 703-622-5195
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Fax |
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Provider Business Mailing Address
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Address Line | 17416 E. PARK
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City | CHINO HILLS
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State | CA
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Zip | 91709
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Country | US
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Telephone | 703-622-5195
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TAMEEM ALHAYYA
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Credential | M.D.
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Telephone | 703-622-5195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State | CA
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