Healthcare Provider Details

I. General information

NPI: 1770904690
Provider Name (Legal Business Name): HORIZON CRITICAL CARE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

IV. Provider business mailing address

2080 CENTURY PARK E
LOS ANGELES CA
90067-2001
US

V. Phone/Fax

Practice location:
  • Phone: 559-901-6484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NATASHA NOORMAND
Title or Position: MEDICAL BILLER
Credential:
Phone: 310-556-0335