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General NPI Number Information
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NPI Number | 1376779058
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Entity Type | Organization
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Legal Business Name | ZOOMMED INC
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 9333 BASELINE RD SUITE 140
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-1350
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Country | US
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Telephone | 909-246-8447
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Fax | 909-614-7168
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Provider Business Mailing Address
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Address Line | 7201 HAVEN AVE SUITE E222
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-6065
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Country | US
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Telephone | 909-246-8447
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Fax | 909-614-7168
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELINA T DOAN
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Credential | M.D.
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Telephone | 909-246-8447
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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 | A104279
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License Number State | CA
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