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General NPI Number Information
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NPI Number | 1649970740
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Entity Type | Organization
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Legal Business Name | INTEGRATED ALLIED MEDICAL GROUP
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 313 E PROVIDENCIA AVE APT F
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City | BURBANK
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State | CA
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Zip | 91502-2720
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Country | US
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Telephone | 323-528-2781
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Fax |
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Provider Business Mailing Address
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Address Line | 313 E PROVIDENCIA AVE APT F
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City | BURBANK
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State | CA
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Zip | 91502-2720
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Country | US
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Telephone | 323-528-2781
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. MAJALIA RIVERA
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Credential |
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Telephone | 323-528-2781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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