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General NPI Number Information
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NPI Number | 1235442989
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Entity Type | Organization
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Legal Business Name | OHS MEDICAL CENTER
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 24578 SUNNYMEAD BLVD C AND D
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3789
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Country | US
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Telephone | 951-924-7550
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Fax | 951-485-8523
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Provider Business Mailing Address
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Address Line | 24578 SUNNYMEAD BLVD C AND D
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3789
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Country | US
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Telephone | 951-924-7550
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Fax | 951-485-8523
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Authorized Official
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Title or Position | OWNER
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Name | DR. ZIZHUANG LI
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Credential | M.D.
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Telephone | 951-924-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | A104536
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License Number State | CA
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