Provider Demographics
NPI:1548784341
Name:PMED3
Entity Type:Organization
Organization Name:PMED3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:626-804-3645
Mailing Address - Street 1:PO BOX 1329
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-1329
Mailing Address - Country:US
Mailing Address - Phone:626-804-3645
Mailing Address - Fax:626-804-3648
Practice Address - Street 1:426 N SAN GABRIEL AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-3451
Practice Address - Country:US
Practice Address - Phone:626-804-3645
Practice Address - Fax:626-804-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory