Healthcare Provider Details

I. General information

NPI: 1346274503
Provider Name (Legal Business Name): CLINICAL HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/21/2022
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 IMPERIAL HWY STE 460
FULLERTON CA
92835-1063
US

IV. Provider business mailing address

251 IMPERIAL HWY STE 460
FULLERTON CA
92835-1063
US

V. Phone/Fax

Practice location:
  • Phone: 714-678-2727
  • Fax: 714-678-2714
Mailing address:
  • Phone: 714-678-2727
  • Fax: 714-678-2714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. STEVE VALLEJOS
Title or Position: OFFICE/PROJECT MANAGER
Credential:
Phone: 714-678-2727