Provider Demographics
NPI:1417241811
Name:SUMMIT HEALTHCARE INC
Entity type:Organization
Organization Name:SUMMIT HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:SAMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-350-6599
Mailing Address - Street 1:22015 MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2942
Mailing Address - Country:US
Mailing Address - Phone:310-850-5630
Mailing Address - Fax:888-944-5233
Practice Address - Street 1:23049 ARCHIBALD AVE
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-4718
Practice Address - Country:US
Practice Address - Phone:310-850-5630
Practice Address - Fax:310-765-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2025-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98537174400000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty