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General NPI Number Information
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NPI Number | 1114656816
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Entity Type | Organization
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Legal Business Name | JOURNEY HEALTH MEDICAL GROUP OF CALIFORNIA
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 2415 HIGH SCHOOL AVE STE 700
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City | CONCORD
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State | CA
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Zip | 94520-1879
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Country | US
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Telephone | 800-674-7967
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Fax | 800-674-7967
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Provider Business Mailing Address
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Address Line | 2415 HIGH SCHOOL AVE STE 700
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City | CONCORD
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State | CA
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Zip | 94520-1879
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Country | US
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Telephone | 800-674-7967
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Fax | 800-674-7967
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP MORRIS
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Credential |
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Telephone | 800-674-7967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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