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NPI Code Detail

MEDICARE: U.S. HEALTHWORKS MEDICAL GROUP OF MINNESOTA, PC

MEDICARE: U.S. HEALTHWORKS MEDICAL GROUP OF MINNESOTA, PC
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 Therapist
22083X0100XOccupational Medicine Physician

General Provider Information

NPI Number : 1285179606
Entity Type Code : Organization
Provider Name (Legal Business Name) : U.S. HEALTHWORKS MEDICAL GROUP OF MINNESOTA, PC
Provider Business Mailing Address
First Line : 25124 SPRINGFIELD CT
Second Line : SUITE 200
City : VALENCIA
State : CA
Zip : 91355-1085
Country : US
Telephone Number : 661-678-2600
Fax Number : 661-678-2700
Provider Business Practice Location Address
First Line : 2520 PILOT KNOB RD
Second Line : SUITE 250
City : MENDOTA HEIGHTS
State : MN
Zip : 55120-1137
Country : US
Telephone Number : 651-224-8264
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOSEPH T MALLAS
Credential :
Telephone Number : 661-678-2600
Provider Enumeration Date : 12/20/2016
Last Update Date : 12/20/2016

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