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Organization
AVALON MEDICAL GROUP OF WHITTIER INC.
Active
Organization
AVALON MEDICAL GROUP OF WHITTIER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE PENN (COMPLIANCE OFFICER)
(818) 461-5030
Entity
Organization
Contact information
Practice address
16030 VENTURA BLVD, STE 200, ENCINO, CA 91436-2754
(818) 461-5030
(818) 461-5095
Mailing address
16030 VENTURA BLVD, STE 200, ENCINO, CA 91436-2754
(818) 461-5030
(818) 461-5095
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
A33793
CA
Other
Enumeration date
04/10/2007
Last updated
07/15/2008
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