Healthcare Provider Details

I. General information

NPI: 1578576880
Provider Name (Legal Business Name): BRIGHT MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15725 E. WHITTIER BLVD
WHITTIER CA
90603
US

IV. Provider business mailing address

12675 LA MIRADA BLVD SUITE 420
LA MIRADA CA
90638
US

V. Phone/Fax

Practice location:
  • Phone: 562-947-8478
  • Fax:
Mailing address:
  • Phone: 562-906-6470
  • Fax: 562-946-9465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number35363
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35363
License Number StateCA

VIII. Authorized Official

Name: KIMBERLY DILLARD
Title or Position: DIRECTOR OF BUSINESS SERVICES
Credential:
Phone: 562-906-6470