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General NPI Number Information
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NPI Number | 1235189978
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Entity Type | Organization
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Legal Business Name | SAN MARCOS MEDICAL GROUP INC.
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 742 W HIGHLAND AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92405-3839
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Country | US
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Telephone | 909-881-7320
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Fax | 909-881-7330
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Provider Business Mailing Address
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Address Line | 742 W HIGHLAND AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92405-3839
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Country | US
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Telephone | 909-881-7320
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Fax | 909-881-7330
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | NATT BALBIR
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Credential | MD
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Telephone | 951-751-5470
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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 | GR0086724
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License Number State | CA
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