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General NPI Number Information
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NPI Number | 1548784341
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Entity Type | Organization
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Legal Business Name | PMED3
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 426 N SAN GABRIEL AVE
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City | AZUSA
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State | CA
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Zip | 91702-3451
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Country | US
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Telephone | 626-804-3645
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Fax | 626-804-3648
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Provider Business Mailing Address
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Address Line | PO BOX 1329
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City | AZUSA
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State | CA
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Zip | 91702-1329
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Country | US
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Telephone | 626-804-3645
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Fax | 626-804-3648
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | DR. STEVE S. SOMMER
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Credential | MD, PHD
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Telephone | 626-804-3645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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