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General NPI Number Information
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NPI Number | 1205874237
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Entity Type | Organization
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Legal Business Name | KINTAUDI & ASSOCIATES MEDICAL GROUP, INC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 1125 CHERRY AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3911
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Country | US
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Telephone | 562-256-1633
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Fax | 562-256-1635
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Provider Business Mailing Address
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Address Line | 1125 CHERRY AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3911
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Country | US
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Telephone | 562-256-1633
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Fax | 562-256-1635
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRUDENCIA KINTAUDI
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Credential | M.D.
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Telephone | 562-256-1633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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