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Organization
POOM MEDICAL CLINIC INC
Active
Organization
POOM MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDA POOMMIPANIT-BAJON MD (SECRETARY)
(808) 419-1187
Entity
Organization
Contact information
Practice address
2055 N PERRIS BLVD STE E6, PERRIS, CA 92571-2517
(951) 940-4176
(951) 940-4038
Mailing address
16293 REGENCY RANCH RD, RIVERSIDE, CA 92504-5654
(808) 419-1187
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A 70122
CA
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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