Provider Demographics
NPI:1861723744
Name:GMC HEALTH SERVICES INC
Entity type:Organization
Organization Name:GMC HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-801-7302
Mailing Address - Street 1:5042 WILSHIRE BLVD
Mailing Address - Street 2:STE 138
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4305
Mailing Address - Country:US
Mailing Address - Phone:909-801-7302
Mailing Address - Fax:909-495-1630
Practice Address - Street 1:328 COMMERCIAL RD
Practice Address - Street 2:STE A101
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3765
Practice Address - Country:US
Practice Address - Phone:909-801-7302
Practice Address - Fax:909-495-1630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-17
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70948207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty