Provider Demographics
NPI:1104037092
Name:MARIA FLORA G. TRIMOR-TAMORIA MEDICAL CLINIC, INC
Entity Type:Organization
Organization Name:MARIA FLORA G. TRIMOR-TAMORIA MEDICAL CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA FLORA
Authorized Official - Middle Name:GALLARDO
Authorized Official - Last Name:TRIMOR-TAMORIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-267-5884
Mailing Address - Street 1:2240 E PLAZA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-5165
Mailing Address - Country:US
Mailing Address - Phone:619-267-5884
Mailing Address - Fax:619-267-6073
Practice Address - Street 1:2240 E PLAZA BLVD STE A
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5165
Practice Address - Country:US
Practice Address - Phone:619-267-5884
Practice Address - Fax:619-267-6073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55589207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty