| Ebtks Medical Center, A Prof Corp. | |
|
4515 Hallmark Pkwy San Bernardino CA 92407-1834 | |
| (909) 648-3551 | |
| Not Available |
| Full Name | Ebtks Medical Center, A Prof Corp. |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 4515 Hallmark Pkwy, San Bernardino, California |
| Authorized Official Name and Position | Michael Joseph Trudeau (CEO) |
| Authorized Official Contact | 9096483551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebtks Medical Center, A Prof Corp. 4515 Hallmark Pkwy San Bernardino CA 92407-1834 Ph: (909) 648-3551 | Ebtks Medical Center, A Prof Corp. 4515 Hallmark Pkwy San Bernardino CA 92407-1834 Ph: (909) 648-3551 |
| NPI Number | 1073872610 |
|---|---|
| Provider Enumeration Date | 05/15/2012 |
| Last Update Date | 04/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073872610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | DC18676 (California) | Primary |
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