Healthcare Provider Details

I. General information

NPI: 1285997668
Provider Name (Legal Business Name): FOCUS MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2079 COMPTON AVE SUITE 102
CORONA CA
92881-7284
US

IV. Provider business mailing address

4475 BIRDIE DR
CORONA CA
92883-0641
US

V. Phone/Fax

Practice location:
  • Phone: 951-735-9599
  • Fax: 951-735-7585
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA84479
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA84479
License Number StateCA

VIII. Authorized Official

Name: QUANG VO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 714-317-4998