Organization
AMVI MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CO D.L. PHAM M.D. (GROUP PRESIDENT)
(714) 796-5900
Entity
Organization
Contact information
Practice address
1920 E. 17TH STREET, SUITE 200, SANTA ANA, CA 92705
(714) 796-5900
(714) 560-7655
Mailing address
1920 E. 17TH STREET, SUITE 200, SANTA ANA, CA 92705
(714) 796-5900
(714) 560-7655
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
A340910
CA
Other
Enumeration date
04/10/2007
Last updated
12/02/2011
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