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NPI Code Detail

MEDICARE: INTERGRO RESOURCES, INC

MEDICARE: INTERGRO RESOURCES, 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
1225100000XPhysical Therapist10360CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BW871AOTHERPTAN

General Provider Information

NPI Number : 1275688756
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERGRO RESOURCES, INC
Provider Business Mailing Address
First Line : 1922 N BROADWAY
Second Line :
City : SANTA ANA
State : CA
Zip : 92706-2610
Country : US
Telephone Number : 714-901-4200
Fax Number : 714-903-9425
Provider Business Practice Location Address
First Line : 1922 N BROADWAY
Second Line :
City : SANTA ANA
State : CA
Zip : 92706-2610
Country : US
Telephone Number : 714-901-4200
Fax Number : 714-903-9425
Authorized Official
Title or Position : CEO
Name : SHERRILYN TONG
Credential : PT
Telephone Number : 714-901-4200
Provider Enumeration Date : 01/24/2007
Last Update Date : 10/12/2016

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