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General NPI Number Information
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NPI Number | 1861902611
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Entity Type | Organization
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Legal Business Name | PRIMER HEALTHCARE
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 24950 REDLANDS BLVD STE F
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City | LOMA LINDA
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State | CA
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Zip | 92354-4028
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Country | US
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Telephone | 909-283-4033
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Fax | 855-621-1987
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Provider Business Mailing Address
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Address Line | 24950 REDLANDS BLVD STE F
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City | LOMA LINDA
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State | CA
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Zip | 92354-4028
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Country | US
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Telephone | 909-283-4033
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Fax | 855-621-1987
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Authorized Official
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Title or Position | CO-OWNER / PARTNER
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Name | DR. PRISCILLA NAAMOMO OTUBUAH
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Credential | NP
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Telephone | 909-283-4033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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