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General NPI Number Information
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NPI Number | 1902313356
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Entity Type | Organization
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Legal Business Name | HUNTINGTON ALIGNED MEDICAL GROUP
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 100 W CALIFORNIA BLVD
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City | PASADENA
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State | CA
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Zip | 91105-3010
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Country | US
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Telephone | 626-623-7415
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Fax |
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Provider Business Mailing Address
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Address Line | 133 N ALTADENA DR FL 2
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City | PASADENA
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State | CA
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Zip | 91107-7325
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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 | INCORPORATOR
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Name | DR. PAULA MARIE VERRETTE
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Credential | MD
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Telephone | 626-397-3577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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