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General NPI Number Information
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NPI Number | 1619307410
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Entity Type | Organization
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Legal Business Name | PALMYRA MEDICAL GROUP INC
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 7521 E HOLLOW OAK RD
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City | ANAHEIM
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State | CA
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Zip | 92808-1429
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Country | US
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Telephone | 657-224-9468
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Fax |
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Provider Business Mailing Address
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Address Line | 7521 E HOLLOW OAK RD
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City | ANAHEIM
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State | CA
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Zip | 92808-1429
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Country | US
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Telephone | 657-224-9468
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Fax |
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Authorized Official
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Title or Position | M.D
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Name | DR. MOHAMAD ALBOUIDANI
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Credential |
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Telephone | 657-224-9468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State | CA
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