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Organization
CENTERS FOR FAMILY MEDICINE GP
Active
Organization
CENTERS FOR FAMILY MEDICINE GP
Active
Other names
OPTUMCARE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR)
(702) 480-2550
Entity
Organization
Contact information
Practice address
3460 KATELLA AVE, LOS ALAMITOS, CA 90720-2334
(562) 594-6599
(562) 598-6220
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 480-2550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
01/29/2007
Last updated
08/02/2024
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