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PROFESSIONAL ADVANTAGE MEDICAL GROUP NPI 1639540560


NPI Information

NPI: 1639540560
Provider Name: PROFESSIONAL ADVANTAGE MEDICAL GROUP
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
1041 E YORBA LINDA BLVD
SUITE 203
PLACENTIA, CA
ZIP 92870
Phone: (714) 985-9110
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PROFESSIONAL ADVANTAGE MEDICAL GROUP is a general practice in Placentia, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PROFESSIONAL ADVANTAGE MEDICAL GROUP NPI is 1639540560. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1041 E YORBA LINDA BLVD
SUITE 203
PLACENTIA, CA
ZIP 92870-728
Phone: (714) 985-9110
Fax: (714) 985-9053

The provider's authorized official is John Gambol .
The authorized official title is C.e.o and has the following contact phone number (850) 233-2228.

The enumeration date for this NPI number is 10/19/2015 and was last updated on 10/30/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeNo
2208D00000XGeneral PracticeG87090CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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