| Provident Hospitalist Associates, A Professional Medical Corporation | |
|
800 S Main St Corona CA 92882-3420 | |
| (951) 737-4343 | |
| Not Available |
| Full Name | Provident Hospitalist Associates, A Professional Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 S Main St, Corona, California |
| Authorized Official Name and Position | Sunil Sujan (CEO) |
| Authorized Official Contact | 3103514566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provident Hospitalist Associates, A Professional Medical Corporation 1191 Magnolia Ave Suite D #248 Corona CA 92879-3215 Ph: (951) 736-6325 | Provident Hospitalist Associates, A Professional Medical Corporation 800 S Main St Corona CA 92882-3420 Ph: (951) 737-4343 |
| NPI Number | 1083998173 |
|---|---|
| Provider Enumeration Date | 10/06/2011 |
| Last Update Date | 10/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083998173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A63079 (California) | Primary |
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