# CROSSOVER HEALTH MEDICAL GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CROSSOVER HEALTH MEDICAL GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831606045
- **Legal business name:** CROSSOVER HEALTH MEDICAL GROUP
- **Authorized official:** ANGIE SAKIOKA (ADMINISTRATION)
- **Authorized official phone:** (949) 891-0328

## Contact information

- **Practice address:** 8000 S FEDERAL WAY \# MS 1-706, BOISE, ID 83716-9632
- **Practice address phone:** (949) 891-0328
- **Mailing address:** 101 W. AVENIDA VISTA HERMOSA, SUITE 120, SAN CLEMENTE, CA 92672
- **Mailing address phone:** (949) 891-0328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2018
- **Last updated:** 01/09/2018