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General NPI Number Information
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NPI Number | 1861723744
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Entity Type | Organization
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Legal Business Name | GMC HEALTH SERVICES INC
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Dates
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Enumeration Date | 01/17/2010
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Last Update Date | 01/17/2010
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Provider Practice Location Address
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Address Line | 328 COMMERCIAL RD STE A101
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3765
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Country | US
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Telephone | 909-801-7302
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Fax | 909-495-1630
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Provider Business Mailing Address
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Address Line | 5042 WILSHIRE BLVD STE 138
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City | LOS ANGELES
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State | CA
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Zip | 90036-4305
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Country | US
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Telephone | 909-801-7302
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Fax | 909-495-1630
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEN ZAFREN
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Credential | M.D.
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Telephone | 909-801-7302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | G70948
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License Number State | CA
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