Healthcare Provider Details

I. General information

NPI: 1174402986
Provider Name (Legal Business Name): NOVOMED MEICAL GROUP INC A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23161 MOULTON PKWY
LAGUNA HILLS CA
92653-1206
US

IV. Provider business mailing address

3485 LEWISTON RD
WEST SACRAMENTO CA
95691-5459
US

V. Phone/Fax

Practice location:
  • Phone: 916-947-0967
  • Fax: 916-844-7635
Mailing address:
  • Phone:
  • Fax: 916-844-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NEDA ARORA
Title or Position: CEO
Credential: MD
Phone: 714-606-0981