Provider Demographics
NPI:1912132754
Name:NOMAR CORPORATION
Entity Type:Organization
Organization Name:NOMAR CORPORATION
Other - Org Name:BALDY VIEW HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:FAKHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-270-0757
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-0579
Mailing Address - Country:US
Mailing Address - Phone:951-270-0757
Mailing Address - Fax:951-270-0758
Practice Address - Street 1:1780 TOWN AND COUNTRY DR
Practice Address - Street 2:SUITE #103
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3617
Practice Address - Country:US
Practice Address - Phone:951-270-0757
Practice Address - Fax:951-270-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP 39009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty