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General NPI Number Information
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NPI Number | 1073680757
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Entity Type | Organization
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Legal Business Name | EL MONTE FAMILY MEDICAL GROUP
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 11227 VALLEY BLVD
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City | EL MONTE
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State | CA
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Zip | 91731
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Country | US
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Telephone | 626-442-7077
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Fax | 626-442-2640
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Provider Business Mailing Address
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Address Line | 11227 VALLEY BLVD
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City | EL MONTE
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State | CA
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Zip | 91731
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Country | US
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Telephone | 626-442-7077
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Fax | 626-442-2640
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | WAEL DAGHER
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Credential | MD
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Telephone | 626-442-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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