Organization
PATHWAY MEDICAL GROUP
Active
Parent organization
MEDVANTX, INC.
Other names
PATHWAY MEDICAL GROUP - WESTMINSTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
7955 WESTMINSTER BLVD, WESTMINSTER, CA 92683-4001
(714) 379-3221
Mailing address
5626 OBERLIN DR, 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A45133
CA
Other
Enumeration date
11/30/2012
Last updated
11/30/2012
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