# SOUTHLAND SAN GABRIEL VALLEY MEDICAL GROUP, INC.

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

## Provider details

- **NPI number:** 1740448786
- **Authorized official:** DR. DAVID T.H. NGUYEN D.O. (PRESIDENT)
- **Authorized official phone:** (626) 782-6202

## Contact information

- **Practice address:** 820 S GARFIELD AVE, SUITE 201 A, ALHAMBRA, CA 91801-5838
- **Practice address phone:** (626) 782-6202
- **Practice address fax:** (626) 249-5399
- **Mailing address:** 820 S GARFIELD AVE, SUITE 201 A, ALHAMBRA, CA 91801-5838
- **Mailing address phone:** (626) 782-6202
- **Mailing address fax:** (626) 249-5399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 05/27/2008
- **Last updated:** 06/23/2014