# CROSSOVER HEALTH MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crossover Health Physical Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790310142
- **Authorized official:** ANGIE SAKIOKA (HR OPERATIONS)
- **Authorized official phone:** (714) 925-4054

## Contact information

- **Practice address:** 925 HAMILTON AVE, MENLO PARK, CA 94025-1431
- **Practice address phone:** (949) 891-0328
- **Mailing address:** 101 W AVENIDA VISTA HERMOSA \# 102, SAN CLEMENTE, CA 92672-7706
- **Mailing address phone:** (949) 891-0328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/05/2020
- **Last updated:** 03/05/2020