Provider Demographics
NPI:1760919492
Name:STRATEGIC MEDICAL PARTNERS A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:STRATEGIC MEDICAL PARTNERS A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-785-0381
Mailing Address - Street 1:10683 MAGNOLIA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-1800
Mailing Address - Country:US
Mailing Address - Phone:951-785-0381
Mailing Address - Fax:951-639-6024
Practice Address - Street 1:10683 MAGNOLIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-1800
Practice Address - Country:US
Practice Address - Phone:951-785-0381
Practice Address - Fax:951-639-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty