Healthcare Provider Details

I. General information

NPI: 1568640571
Provider Name (Legal Business Name): CAMBRIDGE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 PARAMOUNT BLVD SUITE 204A
DOWNEY CA
90241-3331
US

IV. Provider business mailing address

8504 FIRESTONE BLVD SUITE 399
DOWNEY CA
90241-4926
US

V. Phone/Fax

Practice location:
  • Phone: 562-803-6116
  • Fax: 562-803-6308
Mailing address:
  • Phone: 562-803-6116
  • Fax: 562-803-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. WENDY CASTANEDA
Title or Position: ADMINISTRATOR
Credential:
Phone: 562-803-6116