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General NPI Number Information
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NPI Number | 1104710342
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Entity Type | Organization
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Legal Business Name | ADVANTAGE PLUS MEDICAL GROUP
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 1520 NUTMEG PL STE 210
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City | COSTA MESA
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State | CA
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Zip | 92626-2597
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Country | US
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Telephone | 800-698-6151
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 NUTMEG PL STE 210
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City | COSTA MESA
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State | CA
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Zip | 92626-2597
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Country | US
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Telephone | 800-698-6151
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Fax |
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Authorized Official
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Title or Position | LEAD, CREDENTIALING
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Name | AYA GABRIELLE MORALES
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Credential |
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Telephone | 714-487-4482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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