# PEAK HEALTH MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDVANTX, INC.
- **Other names:** Peak Health Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689019382
- **Legal business name:** MEDVANTX, INC.
- **Authorized official:** KENNY HEINE (VP OF OPERATIONS)
- **Authorized official phone:** (858) 964-1506

## Contact information

- **Practice address:** 2143 S SEPULVEDA BLVD, SUITE 300, LOS ANGELES, CA 90025-5733
- **Practice address phone:** (310) 575-3100
- **Mailing address:** 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | A61896 | CA | Yes |

## Other

- **Enumeration date:** 05/08/2013
- **Last updated:** 05/08/2013