Organization
SPA M MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNNIS K. MILLER D.O. (CEO)
(714) 465-7125
Entity
Organization
Contact information
Practice address
32034 BLAZING STAR ST, WINCHESTER, CA 92596-8941
(951) 325-8307
Mailing address
32034 BLAZING STAR ST, WINCHESTER, CA 92596-8941
(951) 325-8307
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
20A8981
CA
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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