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General NPI Number Information
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NPI Number | 1457888034
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA EMERGENCY MEDICINE
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 05/15/2017
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Provider Practice Location Address
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Address Line | 301 W REDLANDS BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4633
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Country | US
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Telephone | 909-335-1900
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Fax | 909-335-0705
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Provider Business Mailing Address
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Address Line | 301 W REDLANDS BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4633
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Country | US
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Telephone | 909-335-1900
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Fax | 909-335-0705
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Authorized Official
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Title or Position | CONTROLLER
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Name | WARREN BRUNK
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Credential |
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Telephone | 909-335-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A73011
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License Number State | CA
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