Ebtks Medical Center, a Prof Corp.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

DC18676 Issued in CA

Legal business name

EBTKS MEDICAL CENTER, A PROF CORP.

Doing business as

Advanced Injury Center

Practice address

4515 Hallmark Pkwy
San Bernardino, CA 92407-1834

Phone

(909) 648-3551

NPI assigned

May 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Joseph Trudeau, DC

Title

Ceo

Phone

(909) 648-3551

Specialties & licenses 2

Addresses

Other names 1

• Advanced Injury Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1073872610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 HALLMARK PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924071834",
            "telephone_number": "909-648-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 HALLMARK PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924071834",
            "telephone_number": "909-648-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBTKS MEDICAL CENTER, A PROF CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "TRUDEAU",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-648-3551",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "DC18676",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Injury Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Injury Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gwendolyn Marcia Easley
• Kathleen Joan Easterwood, LCSW
• Eastfield Ming Quong
• Easy Living Home Healthcare Supplies
• Sara Eberly, M.S.
• Dale L Ecker-Gordon, BA RBT
• Mary Edem, NP
• Deshawn Jahmal Edge-Hughes
• Andrew Edmunds
• Educuras Registered Nursing P.C.

• Health Service Clinic/Center in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.