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Organization
SYMED-CAL MEDICAL GROUP
Active
Organization
SYMED-CAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT)
(800) 370-3651
Entity
Organization
Contact information
Practice address
818 W 7TH ST FL 2, LOS ANGELES, CA 90017-3407
(800) 370-3651
(877) 515-7147
Mailing address
55 HATCHETTS HILL RD, OLD LYME, CT 06371-1534
(800) 370-3651
(877) 515-7147
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE3373
RAILROAD MEDICARE
CA
05
—
GNP000140
—
CA
Enumeration date
05/04/2006
Last updated
07/21/2022
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