Healthcare Provider Details
I. General information
NPI: 1598791972
Provider Name (Legal Business Name): A&G HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2006
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1521 WILSHIRE BLVD
LOS ANGELES CA
90017-2205
US
IV. Provider business mailing address
24 HAMMOND STE C
IRVINE CA
92618
US
V. Phone/Fax
- Phone: 213-250-2250
- Fax:
- Phone: 949-770-6022
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALBERTO
A.
MARCIANO
Title or Position: PRESIDENT
Credential:
Phone: 949-770-6022