# AMVI MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043433220
- **Authorized official:** DR. CO D.L. PHAM M.D. (GROUP PRESIDENT)
- **Authorized official phone:** (714) 796-5900

## Contact information

- **Practice address:** 1920 E. 17TH STREET, SUITE 200, SANTA ANA, CA 92705
- **Practice address phone:** (714) 796-5900
- **Practice address fax:** (714) 560-7655
- **Mailing address:** 1920 E. 17TH STREET, SUITE 200, SANTA ANA, CA 92705
- **Mailing address phone:** (714) 796-5900
- **Mailing address fax:** (714) 560-7655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | A340910 | CA | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 12/02/2011