# PROFESSIONAL ADVANTAGE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1639540560
- **Authorized official:** JOHN GAMBOL (C.E.O)
- **Authorized official phone:** (850) 233-2228

## Contact information

- **Practice address:** 1041 E YORBA LINDA BLVD, SUITE 203, PLACENTIA, CA 92870-3728
- **Practice address phone:** (714) 985-9110
- **Practice address fax:** (714) 985-9053
- **Mailing address:** 38713 TIERRA SUBIDA AVE, SUITE 200-315, PALMDALE, CA 93551-4562
- **Mailing address phone:** (850) 233-2228
- **Mailing address fax:** (714) 985-9053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | G87090 | CA | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 10/19/2015
- **Last updated:** 10/30/2015