Pro Office Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A88502 Issued in NU

Legal business name

PRO OFFICE INC

Practice address

399 E Highland Ave
309
San Bernardino, CA 92404-3808

Phone

(909) 713-9957

NPI assigned

Sep 13, 2010

Last updated

Sep 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Natalya V Sumina, MD

Title

Director

Phone

(909) 713-9957

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1487961421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 MAGNOLIA AVE",
            "address_2": "227",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "909-713-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E HIGHLAND AVE",
            "address_2": "309",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043808",
            "telephone_number": "909-713-9957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO OFFICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "SUMINA",
        "authorized_official_first_name": "NATALYA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-713-9957",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": "A88502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eliana Jolie Provansal

• General Practice Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.