Organization
AGELESS MEN'S HEALTH CA PPC
Active
Other names
Ageless Men's Health
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WILKINSON (BUSINESS OPERATIONS DIRECTOR)
(702) 818-0446
Entity
Organization
Contact information
Practice address
12501 SEAL BEACH BLVD STE 220, SEAL BEACH, CA 90740-2755
(562) 685-9367
Mailing address
12501 SEAL BEACH BLVD STE 220, SEAL BEACH, CA 90740-2755
(949) 854-8378
(949) 854-8379
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/13/2013
Last updated
11/11/2024
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