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General NPI Number Information
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NPI Number | 1255692372
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Entity Type | Organization
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Legal Business Name | SYMONETT FAMILY MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 06/05/2012
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Provider Practice Location Address
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Address Line | 1035 S MOUNT VERNON AVE STE F
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City | COLTON
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State | CA
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Zip | 92324-4207
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Country | US
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Telephone | 909-824-1060
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Fax | 909-824-0501
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Provider Business Mailing Address
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Address Line | 1035 S MOUNT VERNON AVE STE F
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City | COLTON
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State | CA
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Zip | 92324-4207
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Country | US
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Telephone | 909-824-1060
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Fax | 909-824-0501
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ELMER RAYMOND SYMONETT
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Credential | M.D.
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Telephone | 909-824-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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