Residentialist Housecall Medical Group, Pc

NPI 1104205400 - Family Medicine - 207QG0300X

NPI Details
NPI 1104205400
Enumeration Date 05/20/2015
Last Updated 06/19/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name NORMAN EDWARD NORMAN
Position CEO, CFO, AND SECRETARY
Phone (949) 366-1053
Fax (949) 544-7880
Practice Location
4190 CITY AVE
PCOM - ROWLAND HALL, ROOM 528
PHILADELPHIA PA, 19131-1626, US
Phone (949) 366-1053
Fax (949) 544-7880
Business Location
23181 VERDUGO DR
SUITE 103A
LAGUNA HILLS CA, 92653-1357, US
Phone (949) 366-1053
Fax (949) 544-7880
Toxanomy
Taxonomy Code 207QG0300X
License State Pennsylvania
License Number OS017618
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According to our database, Residentialist Housecall Medical Group, Pc NPI is 1104205400, taxonomy code is 207QG0300X and license number is OS017618, license state is located at Pennsylvania. Residentialist Housecall Medical Group, Pc physically located at 4190 City Ave, Philadelphia PA, 19131-1626. NPI Number 1033115704 has the healthcare provider type.

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1104205400 NPI number is provided on an as is basis without warranty of any kind. 1104205400 is maintained by the National Plan & Provider Enumeration System. The contents of Residentialist Housecall Medical Group, Pc are for informational purposes only.