Organization
SOCAL GASTROENTEROLOGY CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVIA JAQUEZ (MANAGER)
(562) 493-1011
Entity
Organization
Contact information
Practice address
10931 CHERRY ST STE 300, LOS ALAMITOS, CA 90720-2496
(562) 493-1011
(562) 594-9226
Mailing address
10931 CHERRY ST STE 300, LOS ALAMITOS, CA 90720-2496
(562) 493-1011
(562) 594-9226
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
03/11/2022
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