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Organization
PROFESSIONAL ADVANTAGE MEDICAL GROUP
Active
Organization
PROFESSIONAL ADVANTAGE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GAMBOL (C.E.O)
(850) 233-2228
Entity
Organization
Contact information
Practice address
1041 E YORBA LINDA BLVD, SUITE 203, PLACENTIA, CA 92870-3728
(714) 985-9110
(714) 985-9053
Mailing address
38713 TIERRA SUBIDA AVE, SUITE 200-315, PALMDALE, CA 93551-4562
(850) 233-2228
(714) 985-9053
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G87090
CA
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
10/19/2015
Last updated
10/30/2015
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