Organization Name: | ALICIA G NUGAS MD INC |
NPI Number: | 1326214818 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHERRYL NUGAS SELBY (ADMINISTRATOR) |
Mailing Address: | 22408 Norwalk Blvd Hawaiian Gardens |
State: | CA US |
Postal Code: | 907161546 |
Phone Number: | 5624212188 |
Fax Number: | 5624213934 |
NPI Enumeration Date: | 05/05/2008 |
NPI Last Update Date: | 05/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | A34342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |