# OMNI INTEGRATED MEDICAL GROUP INC

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

## Provider details

- **NPI number:** 1366208845
- **Authorized official:** ISABELLE SABALONES (PRESIDENT)
- **Authorized official phone:** (760) 220-1991

## Contact information

- **Practice address:** 601 E YORBA LINDA BLVD STE 2G, PLACENTIA, CA 92870-3006
- **Practice address phone:** (760) 220-1991
- **Practice address fax:** (844) 328-5834
- **Mailing address:** 601 E YORBA LINDA BLVD STE 2G, PLACENTIA, CA 92870-3006
- **Mailing address phone:** (760) 220-1991
- **Mailing address fax:** (844) 328-5834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | NULL | — |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/22/2024
- **Last updated:** 02/22/2024