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Organization
PREMIER ENT A MEDICAL CORP
Active
Organization
PREMIER ENT A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAREN KNUDSEN JEFFRIES M.D. (OWNER)
(909) 793-2500
Entity
Organization
Contact information
Practice address
255 TERRACINA BLVD, SUITE 201, REDLANDS, CA 92373-4870
(909) 793-2500
(951) 845-2181
Mailing address
255 TERRACINA BLVD, SUITE 201, REDLANDS, CA 92373-4870
(909) 793-2500
(951) 845-2181
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A50970
CA
Other
Enumeration date
07/05/2007
Last updated
12/01/2008
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