Healthcare Provider Details
I. General information
NPI: 1659562940
Provider Name (Legal Business Name): HEALTHPOINTE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2007
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1171 RAILROAD ST
CORONA CA
92882-7167
US
IV. Provider business mailing address
16702 VALLEY VIEW AVE
LA MIRADA CA
90638-5824
US
V. Phone/Fax
- Phone: 951-272-1400
- Fax: 951-272-9928
- Phone: 714-367-5391
- Fax: 714-635-5428
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | C40558 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
ISAMEL
SILVA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-635-2642