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General NPI Number Information
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NPI Number | 1346843422
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Entity Type | Organization
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Legal Business Name | SEVEN STAR MEDICAL GROUP INC.
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 2390 E FLORIDA AVE STE 104
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City | HEMET
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State | CA
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Zip | 92544-4711
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Country | US
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Telephone | 951-414-4011
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Fax | 951-414-4012
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Provider Business Mailing Address
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Address Line | 41889 FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92544-5042
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Country | US
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Telephone | 951-652-8700
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Fax | 951-414-4012
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | SOPHIE COTA
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Credential | MSHA
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Telephone | 951-929-8149
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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 |
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License Number State |
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