Healthcare Provider Details

I. General information

NPI: 1518456995
Provider Name (Legal Business Name): BMV INVESTMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10130 WARNER AVE STE C
FOUNTAIN VALLEY CA
92708-1619
US

IV. Provider business mailing address

10130 WARNER AVENUE UNIT C
FOUNTAIN VALLEY CA
92708-1619
US

V. Phone/Fax

Practice location:
  • Phone: 714-369-2670
  • Fax:
Mailing address:
  • Phone: 714-369-2670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberG78838
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG78838
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberG78838
License Number StateCA

VIII. Authorized Official

Name: THOMAS VU
Title or Position: OFFICE MANGER
Credential:
Phone: 714-369-2670