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General NPI Number Information
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NPI Number | 1639507247
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Entity Type | Organization
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Legal Business Name | ACHIEVE MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 16200 SAND CANYON AVE HOAG HOSPITAL
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City | IRVINE
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State | CA
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Zip | 92618-3714
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Country | US
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Telephone | 949-349-9264
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Fax |
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Provider Business Mailing Address
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Address Line | 32565B GOLDEN LANTERN ST # 167
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City | DANA POINT
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State | CA
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Zip | 92629-3248
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Country | US
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Telephone | 949-349-9264
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ASHKAN ETEMADIAN
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Credential | D. O.
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Telephone | 949-349-9264
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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 |
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