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General NPI Number Information
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NPI Number | 1861637571
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Entity Type | Organization
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Legal Business Name | AVICURE, INC
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 1201 S BEACH BLVD STE 104B
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City | LA HABRA
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State | CA
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Zip | 90631-6366
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Country | US
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Telephone | 714-253-3021
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S BEACH BLVD STE 104B
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City | LA HABRA
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State | CA
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Zip | 90631-6366
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Country | US
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Telephone | 714-253-3021
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | HELEN KWON
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Credential |
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Telephone | 714-308-4206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | C52804
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License Number State | CA
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