institution
Wilson Gomer M.d. Professional Medical Corporation
Health Service Clinic/Center in San Bernardino, California
NPI 1104327543

Wilson Gomer M.d. Professional Medical Corporation is a Health Service Clinic/Center based in San Bernardino, CA and is specialized in Health Service. Wilson Gomer M.d. Professional Medical Corporation practices in San Bernardino, CA. The NPI Number for Wilson Gomer M.d. Professional Medical Corporation is 1104327543 and holds a License No. A50690 (California).

The current practice location address for Wilson Gomer M.d. Professional Medical Corporation is 1800 Western Ave Ste 103, San Bernardino, CA and can be reached out via phone at 909-887-7427 and via fax at 909-887-7430. You can also correspond with Wilson Gomer M.d. Professional Medical Corporation through the mailing address at 1800 WESTERN AVE STE 103, SAN BERNARDINO, CA - 92411-1352 (mailing address contact number: 909-887-7427).

Location: 1800 Western Ave Ste 103, San Bernardino, CA, 92411-1352
institution
Provider Profile Details
NPI Number
1104327543
Provider Name
Wilson Gomer M.d. Professional Medical Corporation
Credential
Provider Entity Type
Organization
Address
1800 Western Ave Ste 103, San Bernardino, CA, 92411-1352
Phone Number
909-887-7427
Fax Number
909-887-7430
Provider Enumeration Date
02/21/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A506900 05 CA
institution
Provider Business Practice Location Address Details
Address
1800 Western Ave Ste 103
City
State
Zip
92411
Phone Number
909-887-7427
Fax Number
909-887-7430
person
Provider Business Mailing Address Details
Address
1800 Western Ave Ste 103
City
State
Zip
92411
Phone Number
909-887-7427
Fax Number
909-887-7430
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
License No.
A50690 (California)
Definition
Definition to come...
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