Organization Name: | EASTLAND MEDICAL GROUP, INC. |
NPI Number: | 1174678734 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA LONGLEY (CHIEF OF OPERATIONS) |
Mailing Address: | 751 N Todd Ave Azusa |
State: | CA US |
Postal Code: | 917022244 |
Phone Number: | 6269608614 |
Fax Number: | 6269608624 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |