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Organization
KINTAUDI & ASSOCIATES MEDICAL GROUP, INC
Active
Organization
KINTAUDI & ASSOCIATES MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRUDENCIA KINTAUDI M.D. (PRESIDENT)
(562) 256-1633
Entity
Organization
Contact information
Practice address
1125 CHERRY AVE, LONG BEACH, CA 90813-3911
(562) 256-1633
(562) 256-1635
Mailing address
1125 CHERRY AVE, LONG BEACH, CA 90813-3911
(562) 256-1633
(562) 256-1635
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G31192
MEDICAL LICENSE
CA
01
—
WG31192G
PPIN
CA
01
—
WPA11462A
PPIN
CA
Enumeration date
06/03/2006
Last updated
09/24/2007
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