Organization
HARRIMAN JONES MEDICAL GROUP, A PROFESSIONAL CORPORATION
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
4281 KATELLA AVE, SUITE 220, LOS ALAMITOS, CA 90720-3500
(714) 226-0684
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A71791
CA
Other
Enumeration date
02/13/2007
Last updated
12/05/2014
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