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NPI Verification

National Provider Identifier: 1699955575

Active Healthcare Medical Group INC

Organization

Primary Specialty

Family Medicine

Code: 207Q00000X

All Specialties (2)

Physical Therapist

Code: 225100000X

Family Medicine

Code: 207Q00000X

Primary

Practice Address

512 S GLENDORA AVE

WEST COVINA, CA 917903022

Phone: 626-337-2888

NPI Enumeration Date

November 8, 2007

NPI Number

1699955575

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry