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General NPI Number Information
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NPI Number | 1790825545
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Entity Type | Organization
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Legal Business Name | LA PALMA OB GYN MEDICAL GROUP
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5471 LA PALMA AVE STE 200
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City | LA PALMA
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State | CA
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Zip | 90623-4702
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Country | US
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Telephone | 714-670-9444
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Fax | 714-670-0835
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Provider Business Mailing Address
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Address Line | 5471 LA PALMA AVE STE 200
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City | LA PALMA
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State | CA
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Zip | 90623-4702
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Country | US
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Telephone | 714-670-9444
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Fax | 714-670-0835
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Authorized Official
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Title or Position | INSURANCE BILLER
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Name | MRS. DENISE LYNN FIGHT
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Credential |
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Telephone | 562-596-5568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 20A6917
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License Number State | CA
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