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General NPI Number Information
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NPI Number | 1821282104
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Entity Type | Organization
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Legal Business Name | 7 HILLS HEALTH SERVICES
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 12500 BORON AVE
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City | BORON
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State | CA
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Zip | 93516-1647
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Country | US
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Telephone | 760-762-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 12500 BORON AVE
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City | BORON
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State | CA
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Zip | 93516-1647
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PRABHAKAR TUMMALA
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Credential | M.D.
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Telephone | 909-945-7687
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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 | A89858
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | A89858
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | A89858
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License Number State | CA
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