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Organization
MG SAN AYE,M.D.,INC
Active
Organization
MG SAN AYE,M.D.,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MG SAN AYE MD (ATTENDING PHYSICIAN)
(323) 728-7218
Entity
Organization
Contact information
Practice address
1717 W BEVERLY BLVD STE A, MONTEBELLO, CA 90640-3971
(323) 728-7218
Mailing address
1717 W BEVERLY BLVD STE A, MONTEBELLO, CA 90640-3971
(323) 728-7218
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A26642
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A266422
—
CA
Enumeration date
05/18/2007
Last updated
08/22/2020
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