ACCESS ALLIANCE MEDICAL GROUP INC NPI 1629534045

NPI Information

NPI: 1629534045
Provider Name: ACCESS ALLIANCE MEDICAL GROUP, INC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
644 W BROADWAY STE 114
GLENDALE, CA
ZIP 91204
Phone: (323) 899-4988
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ACCESS ALLIANCE MEDICAL GROUP, INC is a primary care nurse practitioner in Glendale, CA. ACCESS ALLIANCE MEDICAL GROUP, INC NPI is 1629534045. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

644 W BROADWAY STE 114
GLENDALE, CA
ZIP 91204-026
Phone: (323) 899-4988

The provider's authorized official is Charlie A Ponce .
The authorized official title is Chief Finance Officer and has the following contact phone number (323) 899-4988.

The enumeration date for this NPI number is 2/11/2019 and was last updated on 2/11/2019.

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
1	363A00000X	Physician Assistant				No
2	363LP2300X	Nurse Practitioner	Primary Care			Yes

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

NPI Synchronization or Removal

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