Organization
IMPALA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT T NGUYEN MD (PRESIDENT/CFO)
(408) 728-3522
Entity
Organization
Contact information
Practice address
2872 N GLASSELL ST, ORANGE, CA 92865-1002
(714) 512-2850
Mailing address
2872 N GLASSELL ST, ORANGE, CA 92865-1002
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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