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General NPI Number Information
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NPI Number | 1346751849
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Entity Type | Organization
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Legal Business Name | MCS MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 12/04/2017
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Provider Practice Location Address
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Address Line | 348 E OLIVE SVE SUITE B1
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City | BURBANK
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State | CA
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Zip | 91502-1235
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Country | US
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Telephone | 310-972-8049
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Fax |
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Provider Business Mailing Address
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Address Line | 348 E OLIVE AVE STE B1
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City | BURBANK
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State | CA
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Zip | 91502-1235
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Country | US
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Telephone | 310-972-8049
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MA CHRISTINA R SALGADO CORTEZ
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Credential |
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Telephone | 310-293-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | CA
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