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General NPI Number Information
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NPI Number | 1760360523
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSOCIATES MEDICAL GROUP INC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 1101 DOVE ST STE 120
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2819
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Country | US
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Telephone | 714-313-1493
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Fax | 951-225-6879
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Provider Business Mailing Address
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Address Line | 1101 DOVE ST STE 120
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2819
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | MS. PRIYA JALOTA
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Credential |
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Telephone | 949-813-4996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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