Healthcare Provider Details

I. General information

NPI: 1891308359
Provider Name (Legal Business Name): CONCIERGE CLINICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13330 BLOOMFIELD AVE STE 209
NORWALK CA
90650-3251
US

IV. Provider business mailing address

13330 BLOOMFIELD AVE STE 209
NORWALK CA
90650-3251
US

V. Phone/Fax

Practice location:
  • Phone: 562-513-2595
  • Fax: 877-280-0040
Mailing address:
  • Phone: 562-513-2595
  • Fax: 877-280-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEEVA M HALL
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 951-547-1670