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Organization
UNITED MEDICAL GROUP, INC.
Active
Organization
UNITED MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHRIYAR TAVAKOLI M.D. (PRESIDENT)
(760) 895-4292
Entity
Organization
Contact information
Practice address
41750 RANCHO LAS PALMAS DR STE M3, RANCHO MIRAGE, CA 92270-5511
(760) 895-4292
(760) 895-4015
Mailing address
PO BOX 1435, RANCHO MIRAGE, CA 92270-1052
(760) 699-7161
(760) 699-7129
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00A485720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ06015Z
GROUP PTAN
CA
Enumeration date
05/04/2007
Last updated
08/24/2020
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