PATHWAY MEDICAL GROUP INC NPI 1407802069

NPI Information

  • NPI: 1407802069
  • Provider Name: PATHWAY MEDICAL GROUP, INC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 05D0576925
  • Address: 12462 BROOKHURST ST
    #A&B
    GARDEN GROVE, CA
    ZIP 92840
  • Phone: (714) 636-9850

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NPI Details

PATHWAY MEDICAL GROUP, INC is a family medicine in Garden Grove, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PATHWAY MEDICAL GROUP, INC NPI is 1407802069. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12462 BROOKHURST ST
#A&B
GARDEN GROVE, CA
ZIP 92840-759
Phone: (714) 636-9850
Fax: (714) 636-1248

The provider's authorized official is Hassan M. Alkhouli .
The authorized official title is C.e.o. and has the following contact phone number (714) 379-3221.

The CLIA number assigned to this NPI record is 05D0576925 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 5/6/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineNo
2363A00000XPhysician AssistantNo
3207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GR0100560MEDICAIDCALIFORNIA
2GR0100561MEDICAIDCALIFORNIA
3W18076AMEDICARE PINCALIFORNIA
4W18076BMEDICARE PINCALIFORNIA

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: 3/30/2025

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