Healthcare Provider Details

I. General information

NPI: 1992386189
Provider Name (Legal Business Name): EMPOWER MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 E KATELLA AVE STE 229
ORANGE CA
92867-4803
US

IV. Provider business mailing address

438 E KATELLA AVE STE 229
ORANGE CA
92867-4803
US

V. Phone/Fax

Practice location:
  • Phone: 714-482-5159
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SYED RAZA RIZVI
Title or Position: CEO
Credential:
Phone: 714-482-5159