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General NPI Number Information
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NPI Number | 1134263817
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Entity Type | Organization
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Legal Business Name | ADVANCED INTEGRATED MEDICAL GROUP
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 100 WEST JACKSON ST
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City | HAYWARD
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State | CA
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Zip | 94544
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Country | US
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Telephone | 510-786-3300
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Fax | 510-786-0280
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Provider Business Mailing Address
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Address Line | 5637 N PERSHING AVE STE F1
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City | STOCKTON
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State | CA
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Zip | 95207
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Country | US
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Telephone | 209-952-8851
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Fax | 209-952-8823
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK LAGOMARSINO
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Credential | DC
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Telephone | 209-932-8851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC27930
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C42153
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License Number State | CA
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