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General NPI Number Information
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NPI Number | 1811192081
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Entity Type | Organization
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Legal Business Name | UNIVERSAL INTEGRATED HEALTH MEDICAL GROUP INC.
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 4100 BIRCH ST., SUITE 200
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-417-0420
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Fax | 877-631-2676
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Provider Business Mailing Address
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Address Line | 4100 BIRCH ST., SUITE 200
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-417-0420
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Fax | 877-631-2676
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Authorized Official
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Title or Position | CEO
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Name | KAMER MIGIRDICHIAN
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Credential |
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Telephone | 949-417-0420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A40490
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License Number State | CA
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