# CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO, A MEDICAL CORPORATI

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COMP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104184860
- **Authorized official:** MR. GREGORY JOSEPH SPEER (ADMINISTRATOR)
- **Authorized official phone:** (951) 222-2206

## Contact information

- **Practice address:** 13800 HEACOCK ST, SUITE C136, MORENO VALLEY, CA 92553-3339
- **Practice address phone:** (951) 656-6009
- **Practice address fax:** (951) 656-6010
- **Mailing address:** 4300 CENTRAL AVE, RIVERSIDE, CA 92506-2918
- **Mailing address phone:** (951) 222-2206
- **Mailing address fax:** (951) 222-2196

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 20A5982 | CA | — |
| 207Q00000X | Family Medicine Physician | A43039 | CA | — |
| 207Q00000X | Family Medicine Physician | A48324 | CA | — |
| 207R00000X | Internal Medicine Physician | 48512 | CA | — |
| 208D00000X | General Practice Physician | 20A9190 | CA | — |
| 208D00000X | General Practice Physician | G70519 | CA | — |
| 208D00000X | General Practice Physician | G72529 | CA | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2012
- **Last updated:** 04/14/2015