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Organization
TUSTIN IRVINE MEDICAL GROUP, INC
Active
Organization
TUSTIN IRVINE MEDICAL GROUP, INC
Active
Parent organization
TUSTIN IRVINE MEDICAL GROUP, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TUSTIN IRVINE MEDICAL GROUP, INC
Authorized official
JOHN ALEVIZOS D.O. (PRESIDENT)
(949) 206-9100
Entity
Organization
Contact information
Practice address
15751 ROCKFIELD BLVD, IRVINE, CA 92618-2832
(949) 206-9100
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/29/2010
Last updated
03/01/2011
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