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General NPI Number Information
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NPI Number | 1225145816
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Entity Type | Organization
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Legal Business Name | CORONA MEDICAL CENTER, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 1157 W GRAND BLVD
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City | CORONA
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State | CA
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Zip | 92882-4364
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Country | US
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Telephone | 951-737-1000
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Fax | 951-737-1558
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Provider Business Mailing Address
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Address Line | PO BOX 3070
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City | CORONA
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State | CA
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Zip | 92878-3070
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Country | US
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Telephone | 951-737-1000
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Fax | 951-737-1558
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IMRAN HASNAIN
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Credential | M.D.
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Telephone | 951-737-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 00A732183
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License Number State | CA
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