Organization
AVALON MEDICAL GROUP OF WHITTIER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE PENN (COMPLIANCE OFFICER)
(818) 461-5030
Entity
Organization
Contact information
Practice address
16030 VENTURA BLVD, STE 200, ENCINO, CA 91436-2754
(818) 461-5030
(818) 461-5095
Mailing address
16030 VENTURA BLVD, STE 200, ENCINO, CA 91436-2754
(818) 461-5030
(818) 461-5095
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
A33793
CA
Other
Enumeration date
04/10/2007
Last updated
07/15/2008
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