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POOM MEDICAL CLINIC INC NPI 1831548197


NPI Information

NPI: 1831548197
Provider Name: POOM MEDICAL CLINIC INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0690392

Address:
2055 N PERRIS BLVD STE E6
PERRIS, CA
ZIP 92571
Phone: (951) 940-4176
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POOM MEDICAL CLINIC INC is a family medicine in Perris, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. POOM MEDICAL CLINIC INC NPI is 1831548197. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2055 N PERRIS BLVD STE E6
PERRIS, CA
ZIP 92571-517
Phone: (951) 940-4176
Fax: (951) 940-4038

The provider's authorized official is Lida Poommipanit-bajon .
The authorized official title is Secretary and has the following contact phone number (808) 419-1187.

The CLIA number assigned to this NPI record is 05D0690392 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/8/2016 and was last updated on 6/8/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineA 70122CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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