Healthcare Provider Details

I. General information

NPI: 1598106312
Provider Name (Legal Business Name): ALLIED PHYSICAL MEDICINE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 W AVENUE J
LANCASTER CA
93534-2936
US

IV. Provider business mailing address

1314 W AVENUE J
LANCASTER CA
93534-2936
US

V. Phone/Fax

Practice location:
  • Phone: 661-945-4441
  • Fax: 661-945-4442
Mailing address:
  • Phone: 661-945-4441
  • Fax: 661-945-4442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG40805
License Number StateCA

VIII. Authorized Official

Name: DR. MARC GREGORY CUBEIRO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 661-945-4441