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General NPI Number Information
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NPI Number | 1154055895
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Entity Type | Organization
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Legal Business Name | EMPIRE HEALTH SYSTEMS OC, INC.
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Dates
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Enumeration Date | 07/10/2022
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Last Update Date | 07/10/2022
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Provider Practice Location Address
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Address Line | 9191 BOLSA AVE STE 208-209
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City | WESTMINSTER
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State | CA
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Zip | 92683-5564
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Country | US
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Telephone | 909-345-5099
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Fax | 818-697-8322
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Provider Business Mailing Address
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Address Line | 9191 BOLSA AVE STE 208-209
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City | WESTMINSTER
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State | CA
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Zip | 92683-5564
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Country | US
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Telephone | 909-345-5099
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. GLADELYNN ADLAO
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Credential | NP
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Telephone | 909-345-5099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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