Healthcare Provider Details

I. General information

NPI: 1427889195
Provider Name (Legal Business Name): ADOBE PH CA MEDICAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S STATE COLLEGE BLVD # 228
BREA CA
92821-5823
US

IV. Provider business mailing address

7500 N DREAMY DRAW DR STE 100
PHOENIX AZ
85020-4668
US

V. Phone/Fax

Practice location:
  • Phone: 480-339-1780
  • Fax:
Mailing address:
  • Phone: 480-339-1780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER FRANGOS
Title or Position: OWNER
Credential: DO
Phone: 480-339-1780