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General NPI Number Information
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NPI Number | 1275823130
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Entity Type | Organization
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Legal Business Name | MVP FAMILY PRACTICE & SPORTS MEDICINE
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 7800 FLORENCE AVE
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City | DOWNEY
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State | CA
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Zip | 90240-3728
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Country | US
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Telephone | 562-928-5700
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Fax | 562-928-5707
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Provider Business Mailing Address
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Address Line | 7800 FLORENCE AVE
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City | DOWNEY
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State | CA
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Zip | 90240-3728
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Country | US
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Telephone | 562-928-5700
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Fax | 562-928-5707
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Authorized Official
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Title or Position | DIRECTOR
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Name | BRIAN C PAYNE
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Credential | MD
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Telephone | 562-928-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | A67059
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A67059
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License Number State | CA
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