Provider Demographics
NPI:1548478316
Name:QUALITY MEDICAL CORPORATION
Entity type:Organization
Organization Name:QUALITY MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:POHANG
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-793-0077
Mailing Address - Street 1:137 E VINE ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4759
Mailing Address - Country:US
Mailing Address - Phone:951-830-2121
Mailing Address - Fax:909-793-8262
Practice Address - Street 1:137 E VINE ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4759
Practice Address - Country:US
Practice Address - Phone:951-830-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAROLD LUKE MD, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-17
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11898208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ18916ZMedicare PIN
CAZZZ17496ZMedicare PIN