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Organization
ACTIVE MOBILE MEDICAL GROUP, INC.
Active
Organization
ACTIVE MOBILE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA BALASICO RN (VICE PRESIDENT)
(213) 465-2643
Entity
Organization
Contact information
Practice address
3450 WILSHIRE BLVD STE 1200, LOS ANGELES, CA 90010-2214
(213) 465-2643
(213) 232-4944
Mailing address
3325 WILSHIRE BLVD STE 208, LOS ANGELES, CA 90010-1733
(213) 465-2643
(213) 232-4944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
02/28/2022
Last updated
03/18/2022
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