Organization
JOHN G. ALEVIZOS DO, INC.
Active
Parent organization
MEDVANTX, INC.
Other names
TUSTIN IRVINE MEDICAL GROUP- SANTA ANA
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
800 N TUSTIN AVE, SUITE A, SANTA ANA, CA 92705-3605
(714) 245-0800
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A37834
CA
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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