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Organization
PATHWAY MEDICAL GROUP, INC
Active
Organization
PATHWAY MEDICAL GROUP, INC
Active
Parent organization
PATHWAY MEDICAL GROUP, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATHWAY MEDICAL GROUP, INC
Authorized official
DR. HASSAN M. ALKHOULI M.D. (C.E.O.)
(714) 379-3221
Entity
Organization
Contact information
Practice address
11100 WARNER AVE, #120, FOUNTAIN VALLEY, CA 92708-7506
(714) 556-8480
(714) 534-0818
Mailing address
PO BOX 2989, SEAL BEACH, CA 90740-1989
(714) 379-3221
(714) 379-3211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0100560
—
CA
Enumeration date
05/26/2006
Last updated
05/06/2008
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