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General NPI Number Information
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NPI Number | 1295369791
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Entity Type | Organization
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Legal Business Name | CENTRO MEDICO GENERAL, INC.
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 2090 S EUCLID ST
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City | ANAHEIM
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State | CA
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Zip | 92802-3143
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Country | US
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Telephone | 714-539-2200
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Fax | 714-539-2277
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Provider Business Mailing Address
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Address Line | 2090 S EUCLID ST
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City | ANAHEIM
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State | CA
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Zip | 92802-3143
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Country | US
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Telephone | 714-539-2200
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DIEGO IVAN KRIGER
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Credential | MD
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Telephone | 951-822-7191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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