EBTKS MEDICAL CENTER, A PROF CORP.


Address: 4515 Hallmark Pkwy, San Bernardino, CA 92407-1834
Phone: 9096483551

EBTKS MEDICAL CENTER, A PROF CORP. (NPI# 1073872610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073872610
Entity Type Organization
Organization Name EBTKS MEDICAL CENTER, A PROF CORP.
Other Organization Name ADVANCED INJURY CENTER
Practice Address 4515 Hallmark Pkwy
San Bernardino
CA 92407-1834
Practice Telephone 9096483551
Mailing Telephone 9096483551
Enumeration Date 2012-05-15
Last Update Date 2018-04-30
Authorized Official Name MICHAEL JOSEPH TRUDEAU (CEO)
Authorized Official Telephone 9096483551
Authorized Official Credential DC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities
Y 261QH0100X Clinic/Center
Specialization: Health Service
DC18676 CA Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Advanced Injury Center Doing Business As Name - Organization

Office Location

Street Address 4515 HALLMARK PKWY
City SAN BERNARDINO
State CA
Zip Code 92407-1834

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689699233 Michael Joseph Trudeau Chiropractor 4515 Hallmark Pkwy, San Bernardino, CA 92407-1834 2006-07-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1639789233 Luis Enrique Macias Case Manager/Care Coordinator 26967 Beaumont Ave., Redlands Ca 92373, San Bernardino, CA 92407 2020-08-07
1619526209 Louise E Curran Social Worker 6395 N Azalea Ave, San Bernardino, CA 92407 2019-09-06
1619496049 Portia Monique Jackson Licensed Vocational Nurse 1022 Sunbrook Dr., San Bernardino, CA 92407 2017-09-18
1568988467 Jon Michael Hensley Behavior Technician 1638 Windsor Street, San Bernardino, CA 92407 2017-08-22
1063933349 Priority Rounds Transport, L.l.c Non-emergency Medical Transport (VAN) 18245 Evening Primrose Ln, San Bernardino, CA 92407 2017-06-27
1760927263 Denkorach Inc In Home Supportive Care 1265 Kendall Drive, Unit 1614, San Bernardino, CA 92407 2016-12-20
1558606517 Pradeep Amin Pharmacist 4150 N Sierra Way, San Bernardino, CA 92407 2012-12-03
1811231384 Lucindy Thomasina Fuller Rehabilitation Practitioner 1265 Kendall Dr, San Bernardino, CA 92407 2012-11-21
1578793337 Shareela Marie Allen Social Worker 6791 N. Ofeila Drive, San Bernardino, CA 92407 2009-07-15
1720239304 Alejandro Paul Holguin Social Worker 6076 Norma Ln, San Bernardino, CA 92407 2008-10-01
Find all providers in zip 92407

Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104327543 Wilson Gomer M.d. Professional Medical Corporation Clinic/Center 1800 Western Ave Ste 103, San Bernardino, CA 92411 2018-02-21
1407189525 San Bernardino Valley College, Student Health Services Clinic/Center 701 S Mount Vernon Ave, Student Health Services, San Bernardino, CA 92410-2705 2009-09-08
1225273600 Ayla Corporation Clinic/Center 164 W Hospitality Ln Ste 7, San Bernardino, CA 92408-3329 2008-12-12
1982246872 Occupational Health Centers of California, A Medical Corporation Clinic/Center 1910 E Central Ave, San Bernardino, CA 92408-0123 2019-10-11
1851868012 Occupational Health Centers of California, A Medical Corporation Clinic/Center 599 Inland Center Dr Ste 105, San Bernardino, CA 92408-1819 2018-10-25
1053438408 H Street Medical Associates, Inc Clinic/Center 1329 N H St, San Bernardino, CA 92405-5039 2007-03-23

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NPI Name Taxonomy Address Enumeration
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1134736705 Boston Medical Center Inc Clinic/Center 960 E Green St Ste 101, Pasadena, CA 91106-2401 2020-09-28
1215541628 Pacific Care II Clinic/Center 1024 Jayhawk Way, Modesto, CA 95358-6714 2020-09-02
1316557358 Breathe Thermae, Inc. Clinic/Center 200 S Cahuilla Rd, Palm Springs, CA 92262-6334 2020-08-04
1497363212 Joana Anjeh Tala Clinic/Center 2951 Hampshire Cir, Corona, CA 92879-6133 2020-07-17
1376160580 Beyond Practice, Inc. Clinic/Center 300 W Ocean Blvd Apt 6114, Long Beach, CA 90802-8029 2020-07-03
1205452315 Affection Healthcare LLC Clinic/Center 1641 North Ripon Road, Ripon, CA 95366 2020-06-24
1467074963 Onclick Healthcare Incorporated Clinic/Center 2625 Townsgate Rd Ste 330, Westlake Village, CA 91361-5749 2020-05-07
1811517832 D.e. Garrison, D.o., Inc. Clinic/Center 3209 Esplanade Ste 120, Chico, CA 95973-0154 2020-04-20
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Competitor

Search similar providers

City SAN BERNARDINO
Zip Code 92407

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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