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Organization
MAGELLA MEDICAL GROUP, INC.
Active
Organization
MAGELLA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R SANTANA (ASSISTANT SECRETARY)
(800) 243-3839
Entity
Organization
Contact information
Practice address
2888 LONG BEACH BLVD STE 400, LONG BEACH, CA 90806-1553
(562) 997-8510
(562) 997-8520
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
09/17/2006
Last updated
10/18/2024
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