| Orange County Professional Medical Group | |
|
4103 N Viking Way Suite D Long Beach CA 90808-1490 | |
| (714) 600-6760 | |
| (714) 935-9559 |
| Full Name | Orange County Professional Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4103 N Viking Way, Long Beach, California |
| Authorized Official Name and Position | Holly Sata (PRESIDENT) |
| Authorized Official Contact | 7146006760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange County Professional Medical Group 4103 N Viking Way Suite D Long Beach CA 90808-1490 Ph: (714) 600-6760 | Orange County Professional Medical Group 4103 N Viking Way Suite D Long Beach CA 90808-1490 Ph: (714) 600-6760 |
| NPI Number | 1457886236 |
|---|---|
| Provider Enumeration Date | 04/28/2017 |
| Last Update Date | 04/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457886236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | G71823 (California) | Primary |
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