Provider Demographics
NPI:1295338374
Name:SEVEN STAR MEDICAL GROUP INC.
Entity type:Organization
Organization Name:SEVEN STAR MEDICAL GROUP INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF SURGICAL SERV
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:519-765-1717
Mailing Address - Street 1:41889 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-5042
Mailing Address - Country:US
Mailing Address - Phone:951-765-1717
Mailing Address - Fax:888-827-0236
Practice Address - Street 1:41889 EAST FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544
Practice Address - Country:US
Practice Address - Phone:951-652-8700
Practice Address - Fax:888-827-0236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty