Organization Name: | ADVANCED MULTI SPECIALTY MEDICAL GROUP |
NPI Number: | 1073712162 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS VAMVOURIS (PARTNER) |
Mailing Address: | 37471 Fremont Blvd Fremont |
State: | CA US |
Postal Code: | 945363704 |
Phone Number: | 5107425900 |
Fax Number: | 5107425910 |
NPI Enumeration Date: | 07/17/2007 |
NPI Last Update Date: | 06/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |