PREMIER SENIOR MEDICAL GROUP OF SAN BERNARDINO, INC. (NPI# 1689166241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689166241 |
| Entity Type | Organization |
| Organization Name | PREMIER SENIOR MEDICAL GROUP OF SAN BERNARDINO, INC. |
| Practice Address |
284 E Highland Ave San Bernardino CA 92404-3706 |
| Mailing Address |
31938 Temecula Pkwy Ste A237 Temecula CA 92592-6810 |
| Practice Telephone | 9098831098 |
| Mailing Telephone | 7144143065 |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2018-05-30 |
| Authorized Official Name | DAVID JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 2072175451 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
284 E HIGHLAND AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-3706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881183713 | Judy Hsieh | Physician Assistant | 284 E Highland Ave, San Bernardino, CA 92404-3706 | 2018-05-07 |
| 1619451168 | Medx-imaging Services | Radiology | 284 E Highland Ave, San Bernardino, CA 92404-3706 | 2018-09-20 |
| 1871085431 | Premier Family Medical Group | Family Medicine | 284 E Highland Ave, San Bernardino, CA 92404-3706 | 2018-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790237485 | Kate Donkor | Family Medicine | 2564 Winston Ct, San Bernardino, CA 92408 | 2016-10-27 |
| 1215182803 | Gospha G, Campbell Md Inc | Family Medicine | 1850 S Waterman Ave # F, San Bernardino, CA 92408-2877 | 2008-11-24 |
| 1538592506 | Abigail Soto | Family Medicine | 598 N F St, San Bernardino, CA 92410-3110 | 2013-08-14 |
| 1801094149 | Mill-waterman Medical Corporation | Family Medicine | 385 E Mill St Ste 13, San Bernardino, CA 92408-1545 | 2007-07-09 |
| 1861602021 | Richelle Marracino | Family Medicine | 5500 University Parkway, Csusb Student Health Center, San Bernardino, CA 92407 | 2007-05-23 |
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| 1669092854 | Wellbeing Clinic Inc | Family Medicine | 1621 S New Hampshire Ave, Los Angeles, CA 90006-4513 | 2020-04-17 |
| 1619513611 | Krista Mckinney | Family Medicine | 344o E. La Palma Avenue, Anaheim, CA 92806 | 2019-11-25 |
| 1457995565 | Ucsf Medical Group Business Services | Family Medicine | 1100 Park Pl Ste 100, San Mateo, CA 94403-7119 | 2019-10-31 |
| 1780237313 | Charles Kim Md Inc | Family Medicine | 3055 W Orange Ave Ste 204, Anaheim, CA 92804-3154 | 2019-07-23 |
| 1083277206 | Baum 5 Star Healthcare | Family Medicine | 560 W Grangeville Blvd Ste A, Hanford, CA 93230-2858 | 2019-04-15 |
| 1477025278 | Connexus Family Clinic Inc | Family Medicine | 1930 E. Anaheim Street, N/a, Long Beach, CA 90813-3908 | 2018-12-19 |
| Find all providers with the same taxonomy | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
Please comment or provide details below to improve the information on PREMIER SENIOR MEDICAL GROUP OF SAN BERNARDINO, INC..
| 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.