CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO A MEDICAL CORPORATI NPI 1104184860

NPI Information

  • NPI: 1104184860
  • Provider Name: CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO, A MEDICAL CORPORATI
  • Classification: Clinic/Center - 261QX0100X
  • Specialization: Occupational Medicine
  • Entity Type: Organization
  • Other Name: COMP
  • CLIA Number: 05D2161544
  • Address: 13800 HEACOCK ST
    SUITE C136
    MORENO VALLEY, CA
    ZIP 92553
  • Phone: (951) 656-6009

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NPI Details

CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO, A MEDICAL CORPORATI is an occupational medicine clinic center in Moreno Valley, CA. CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO, A MEDICAL CORPORATI NPI is 1104184860. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Comp.

The provider's business location address is:

13800 HEACOCK ST
SUITE C136
MORENO VALLEY, CA
ZIP 92553-339
Phone: (951) 656-6009
Fax: (951) 656-6010

The provider's authorized official is Gregory Joseph Speer .
The authorized official title is Administrator and has the following contact phone number (951) 222-2206.

The CLIA number assigned to this NPI record is 05D2161544 - industrial with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2012 and was last updated on 4/14/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineA48324CALIFORNIANo
2207Q00000XFamily MedicineA43039CALIFORNIANo
3207Q00000XFamily Medicine20A5982CALIFORNIANo
4207R00000XInternal Medicine48512CALIFORNIANo
5208D00000XGeneral PracticeG70519CALIFORNIANo
6208D00000XGeneral Practice20A9190CALIFORNIANo
7208D00000XGeneral PracticeG72529CALIFORNIANo
8261QX0100XClinic/CenterOccupational MedicineYes

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: 3/30/2025

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