Healthcare Provider Details
I. General information
NPI: 1093152241
Provider Name (Legal Business Name): U.S. HEALTHWORKS MEDICAL GROUP OF KANSAS CITY, P.A
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2013
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25124 SPRINGFIELD CT SUITE 200
VALENCIA CA
91355-1085
US
IV. Provider business mailing address
25124 SPRINGFIELD CT SUITE 200
VALENCIA CA
91355-1085
US
V. Phone/Fax
- Phone: 661-678-2600
- Fax: 661-678-2700
- Phone: 661-678-2600
- Fax: 661-678-2700
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0500X |
| Taxonomy | Preventive Medicine/Occupational Environmental Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSEPH
MALLAS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 661-678-2600