Healthcare Provider Details

I. General information

NPI: 1144769605
Provider Name (Legal Business Name): NEXUS HEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2017
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 E LA PALMA AVE STE 201
ANAHEIM CA
92807-2081
US

IV. Provider business mailing address

5100 E LA PALMA AVE STE 201
ANAHEIM CA
92807-2081
US

V. Phone/Fax

Practice location:
  • Phone: 714-883-1604
  • Fax:
Mailing address:
  • Phone: 714-883-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberA34641
License Number StateCA

VIII. Authorized Official

Name: DR. CARLOS DAYRIT
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 562-547-2006