Provider Demographics
NPI:1669737508
Name:OPTIONS MEDICAL CENTER, INC
Entity type:Organization
Organization Name:OPTIONS MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KERK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-246-6600
Mailing Address - Street 1:11497 BARTLETT AVE STE B1
Mailing Address - Street 2:
Mailing Address - City:ADELANTO
Mailing Address - State:CA
Mailing Address - Zip Code:92301-1901
Mailing Address - Country:US
Mailing Address - Phone:760-246-6600
Mailing Address - Fax:760-246-6608
Practice Address - Street 1:11497 BARTLETT AVE STE B1
Practice Address - Street 2:
Practice Address - City:ADELANTO
Practice Address - State:CA
Practice Address - Zip Code:92301-1901
Practice Address - Country:US
Practice Address - Phone:760-246-6600
Practice Address - Fax:760-246-6608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108988261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care