Provider Demographics
NPI:1245064609
Name:SUMMIT MEDICAL PARTNERS
Entity type:Organization
Organization Name:SUMMIT MEDICAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GABBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-273-7100
Mailing Address - Street 1:38656 MEDICAL CENTER DR STE C
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4695
Mailing Address - Country:US
Mailing Address - Phone:661-271-7300
Mailing Address - Fax:
Practice Address - Street 1:38656 MEDICAL CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4695
Practice Address - Country:US
Practice Address - Phone:661-271-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTELOPE VALLEY SUMMIT MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty