Provider Demographics
NPI:1942834189
Name:DRMOVI, INC
Entity Type:Organization
Organization Name:DRMOVI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-345-5111
Mailing Address - Street 1:1360 VALLEY VISTA DR STE 209
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3953
Mailing Address - Country:US
Mailing Address - Phone:909-345-5111
Mailing Address - Fax:
Practice Address - Street 1:6850 LINCOLN AVE STE 102
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4179
Practice Address - Country:US
Practice Address - Phone:909-345-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty