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General NPI Number Information
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NPI Number | 1114558350
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Entity Type | Organization
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Legal Business Name | KIDSTRONG MEDICAL GROUP INC.
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 220 LAGUNA RD STE 5
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City | FULLERTON
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State | CA
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Zip | 92835-2523
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Country | US
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Telephone | 714-879-2980
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Fax |
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Provider Business Mailing Address
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Address Line | 2618 SAN MIGUEL DR STE 464
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5437
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUNJEET KALA AHLUWALIA
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Credential | MD
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Telephone | 714-707-0034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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