Organization Name: | ALLIANCE PHYSICIANS MEDICAL GROUP |
NPI Number: | 1770785818 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BONNIE ENG (PROVIDER RELATIONS MANAGER) |
Mailing Address: | 4909 Lakewood Blvd 200 Lakewood |
State: | CA US |
Postal Code: | 907122405 |
Phone Number: | 5626021563 |
Fax Number: | |
NPI Enumeration Date: | 06/01/2007 |
NPI Last Update Date: | 07/08/2007 |
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: |