Mesa Advantage Medical Group
NPI #1578017778 in San Marino, California
Provider Information
- NPI Number
- 1578017778
- Entity Type
- Organization
- Organization Name
- Mesa Advantage Medical Group
- Primary Specialty
- Exclusive Provider Organization
- Enumeration Date
- Aug 5, 2016
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 2295 HUNTINGTON DR # D
- City
- San Marino
- State
- California
- ZIP Code
- 91108-2640
- Phone
- (626) 656-2370
Authorized Official
- Name
- MS. LAN NHU BICH PHAN
- Title
- CEO
- Phone
- (818) 399-8996
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
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