# PREMIER SENIOR MEDICAL GROUP OF SAN BERNARDINO, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689166241
- **Authorized official:** DAVID JOHNSON MD (PRESIDENT)
- **Authorized official phone:** (207) 217-5451

## Contact information

- **Practice address:** 284 E HIGHLAND AVE, SAN BERNARDINO, CA 92404-3706
- **Practice address phone:** (909) 883-1098
- **Mailing address:** 31938 TEMECULA PKWY STE A237, TEMECULA, CA 92592-6810
- **Mailing address phone:** (714) 414-3065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/30/2018
- **Last updated:** 05/30/2018