Organization
MARLBORO CANCER SCREENING CENTER INC
Active
Other names
MARLBORO CANCER SCREENING CENTER INC
Organization subpart
No
Provider details
NPI number
Authorized official
DHARMAKUMAR WILSON GOMER MD (MEDICAL DIRECTOR)
(909) 799-5445
Entity
Organization
Contact information
Practice address
11340 MOUNTAIN VIEW AVE STE B, LOMA LINDA, CA 92354-3858
(888) 267-9605
(909) 334-1314
Mailing address
14164 MOUNTAIN AVE, CHINO, CA 91710-1128
(909) 927-8296
(909) 334-1314
Taxonomy
Speciality
Code
Description
License number
State
261QG0250X
Genetics Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CA361389
—
CA
Enumeration date
06/05/2019
Last updated
09/17/2019
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