Healthcare Provider Details
I. General information
NPI: 1063691988
Provider Name (Legal Business Name): A&G HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2007
Last Update Date: 10/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5810 DOWNEY AVE
LONG BEACH CA
90805-4517
US
IV. Provider business mailing address
24 HAMMOND STE C
IRVINE CA
92618-1680
US
V. Phone/Fax
- Phone: 562-398-0200
- Fax: 562-398-0204
- Phone: 949-770-6022
- Fax: 949-770-7084
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALBERTO
A.
MARCIANO
Title or Position: OWNER
Credential:
Phone: 949-770-6022