# CROSSOVER HEALTH MEDICAL GROUP

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

## Provider details

- **NPI number:** 1447643804
- **Authorized official:** ANGIE SAKIOKA (ADMINISTRATION)
- **Authorized official phone:** (949) 891-0328

## Contact information

- **Practice address:** 806 JACKSON ST, COLUMBUS, IN 47201-6264
- **Practice address phone:** (949) 891-0328
- **Practice address fax:** (949) 272-0159
- **Mailing address:** 65 ENTERPRISE, ALISO VIEJO, CA 92656-2705
- **Mailing address phone:** (949) 891-0328
- **Mailing address fax:** (949) 272-0159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A74385 | CA | Yes |

## Other

- **Enumeration date:** 03/10/2015
- **Last updated:** 03/10/2015