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General NPI Number Information
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NPI Number | 1912132754
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Entity Type | Organization
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Legal Business Name | NOMAR CORPORATION
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 1780 TOWN AND COUNTRY DR SUITE #103
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City | NORCO
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State | CA
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Zip | 92860-3617
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Country | US
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Telephone | 951-270-0757
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Fax | 951-270-0758
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Provider Business Mailing Address
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Address Line | PO BOX 579
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City | NORCO
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State | CA
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Zip | 92860-0579
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Country | US
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Telephone | 951-270-0757
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Fax | 951-270-0758
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RAMON FAKHOURY
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Credential | M.D.
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Telephone | 951-270-0757
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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 | FNP 39009
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License Number State | CA
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