Provider Demographics
NPI:1710331400
Name:SUMMITH HEALLTHCARE INC
Entity Type:Organization
Organization Name:SUMMITH HEALLTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-850-5630
Mailing Address - Street 1:23049 ARCHIBALD AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-4718
Mailing Address - Country:US
Mailing Address - Phone:310-850-5630
Mailing Address - Fax:
Practice Address - Street 1:23049 ARCHIBALD AVE
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-4718
Practice Address - Country:US
Practice Address - Phone:310-850-5630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004061314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility