NPIMap

Central Occupational Medicine Providers - Ontario, a Medical Corporati

Organization Active NPI Occupational Medicine Clinic/Center · San Bernardino, CA

NPI 1760740336 · NPPES record last updated Apr 14, 2015

Key facts

NPI
1760740336
Entity type
Organization (NPI type 2)
Primary specialty
Occupational Medicine Clinic/Center 261QX0100X
Legal business name
CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO, A MEDICAL CORPORATI
Practice address
295 E Caroline St
Suite D-1
San Bernardino, CA 92408-3700
Phone
(909) 723-1161
Fax
(909) 723-1168
NPI assigned
May 2, 2012
Organization subpart
No

Authorized official

Name
Mr. Gregory Joseph Speer
Title
Administrator
Phone
(951) 222-2206

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2161547Central Occupational Medicine Providers
295 E Caroline St, D1, San Bernardino, CA 92408		Certificate of waiverFeb 4, 2027

National Provider Directory

Tax ID family
Central Occupational Medicine Providers - Ontario a Medical Corporati (6 organizations share this tax ID)

Locations

295 E Caroline St
Ste D1
San Bernardino, CA 92408
Phone (909) 723-1161

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207Q00000X A48324 CA
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207Q00000X A43039 CA
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207Q00000X 20A5982 CA
Internal Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207R00000X A48512 CA
General Practice Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 208D00000X G70519 CA
General Practice Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 208D00000X 20A9190 CA
General Practice Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 208D00000X G72529 CA
Occupational Medicine Clinic/Center 261QX0100X Yes
Medical Physician Assistant
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363AM0700X PA52001 CA

Addresses

Primary practice location

295 E Caroline St
Suite D-1
San Bernardino, CA 92408-3700

Mailing address

4300 Central Ave
Riverside, CA 92506-2918
Phone (951) 222-2206

Other names

  • COMP Other name

Other providers in San Bernardino, CA

All providers in San Bernardino, CA · Occupational Medicine Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.