# CONCENTRA MEDICAL CENTER

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

## Provider details

- **NPI number:** 1720295744
- **Authorized official:** MR. JAY MYRON FULLER PTA (PHYSICAL THERAPIST ASSISTANT)
- **Authorized official phone:** (714) 522-8051

## Contact information

- **Practice address:** 26 CENTERPOINTE DR, 115, LA PALMA, CA 90623-1072
- **Practice address phone:** (714) 522-8051
- **Practice address fax:** (714) 522-5703
- **Mailing address:** 26 CENTERPOINTE DR, 115, LA PALMA, CA 90623-1072
- **Mailing address phone:** (714) 522-8051
- **Mailing address fax:** (714) 522-5703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | AT3551 | CA | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 08/22/2020