Healthcare Provider Details
I. General information
NPI: 1962986281
Provider Name (Legal Business Name): SYMMETRY MEDICAL INFUSIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2018
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17822 BEACH BLVD STE 473
HUNTINGTON BEACH CA
92647
US
IV. Provider business mailing address
3943 IRVINE BLVD STE 628
IRVINE CA
92602-2400
US
V. Phone/Fax
- Phone: 714-274-9536
- Fax: 714-333-4486
- Phone: 310-740-7864
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QI0500X |
| Taxonomy | Infusion Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JANETTE
GRAY
Title or Position: MEDICAL DIREC
Credential: MD
Phone: 714-274-9536