| Marc H. Shomer, Md, Phd, Inc | |
|
820 N Mountain Ave Ste 102 Upland CA 91786-4163 | |
| (909) 981-9800 | |
| (909) 946-3937 |
| Full Name | Marc H. Shomer, Md, Phd, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 820 N Mountain Ave Ste 102, Upland, California |
| Authorized Official Name and Position | Marc Howard Shomer (CEO) |
| Authorized Official Contact | 9096368586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marc H. Shomer, Md, Phd, Inc Po Box 1075 Dana Point CA 92629-5075 Ph: (909) 981-9800 | Marc H. Shomer, Md, Phd, Inc 820 N Mountain Ave Ste 102 Upland CA 91786-4163 Ph: (909) 981-9800 |
| NPI Number | 1427380070 |
|---|---|
| Provider Enumeration Date | 02/08/2010 |
| Last Update Date | 02/02/2021 |
| Medicare PECOS PAC ID | 0547453888 |
|---|---|
| Medicare Enrollment ID | O20101019001651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427380070 | NPI | - | NPPES |
| CZ142A | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | A95190 (California) | Primary |
| Provider Name | Marc H Shomer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457457483 PECOS PAC ID: 3072674803 Enrollment ID: I20081211000279 |
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