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General NPI Number Information
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NPI Number | 1649458217
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Entity Type | Organization
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Legal Business Name | WESTERN MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 21081 S WESTERN AVE STE 150
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City | TORRANCE
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State | CA
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Zip | 90501-1707
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Country | US
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Telephone | 310-782-3333
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Fax | 310-212-6230
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Provider Business Mailing Address
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Address Line | 21081 S WESTERN AVE STE 150
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City | TORRANCE
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State | CA
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Zip | 90501-1707
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Country | US
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Telephone | 310-782-3333
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Fax | 310-212-6230
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GARY BARLOW
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Credential | PA
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Telephone | 310-782-3336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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