Organization
ASSOCIATED GASTROENTEROLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI HALL (OFFICE MANAGER)
(714) 778-1300
Entity
Organization
Contact information
Practice address
1211 W LA PALMA AVE, STE 306, ANAHEIM, CA 92801-2811
(714) 778-1300
(714) 778-0303
Mailing address
1211 W LA PALMA AVE, STE 306, ANAHEIM, CA 92801-2811
(714) 778-1300
(714) 778-0303
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ83646Z
—
CA
Enumeration date
06/27/2005
Last updated
08/18/2010
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