Healthcare Provider Details

I. General information

NPI: 1851528830
Provider Name (Legal Business Name): HEALTHPOINTE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N VERDUGO RD
GLENDALE CA
91206-3944
US

IV. Provider business mailing address

PO BOX 4499
CERRITOS CA
90703-4499
US

V. Phone/Fax

Practice location:
  • Phone: 818-247-1331
  • Fax: 818-553-1720
Mailing address:
  • Phone: 714-367-5310
  • Fax: 714-533-3712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC40558
License Number StateCA

VIII. Authorized Official

Name: DR. ISMAEL SILVA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-367-5310