Organization
RESIDENTIALIST HOUSECALL MED GRP, PC A PENNSYLVANIA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARIE WALTON (BILLING MANAGER)
(949) 366-1053
Entity
Organization
Contact information
Practice address
4190 CITY AVE, PCOM - ROWLAND HALL, ROOM 528, PHILADELPHIA, PA 19131-1626
(949) 366-1053
(949) 544-7880
Mailing address
3800 KILROY AIRPORT WAY STE 270, LONG BEACH, CA 90806-2497
(949) 366-1053
(949) 916-0387
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
OS017618
PA
Other
Enumeration date
05/20/2015
Last updated
03/05/2025
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