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NPI Code Detail

MEDICARE: SEAL BEACH FAMILY MEDICAL GROUP, INC.

MEDICARE: SEAL BEACH FAMILY MEDICAL GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1215041801
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEAL BEACH FAMILY MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : 1198 PACIFIC COAST HWY
Second Line : SUITE I
City : SEAL BEACH
State : CA
Zip : 90740-6251
Country : US
Telephone Number : 562-799-7071
Fax Number : 562-594-5627
Provider Business Practice Location Address
First Line : 1198 PACIFIC COAST HWY
Second Line : SUITE I
City : SEAL BEACH
State : CA
Zip : 90740-6251
Country : US
Telephone Number : 562-799-7071
Fax Number : 562-594-5627
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. JOHN M TURNER
Credential : M.D.
Telephone Number : 562-799-7071
Provider Enumeration Date : 08/19/2006
Last Update Date : 10/08/2008

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1417966383 — JOHN MACDONALD TURNER M.D.
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1831251990 — MRS. ELLIE M FONG PA-C
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1124166772 — MRS. OURANIA ZOIE PAPANTONIADIS PA-C
Practice Location Address:
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Practice Phone: 562-799-7071
Practice Fax: 562-594-5627

Directions to “SEAL BEACH FAMILY MEDICAL GROUP, INC. ” Practice Location

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