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Organization

AG INFECTIOUS DISEASES, A MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ARIC GREGSON MD (PHYSICIAN)
(424) 256-6682
Entity
Organization

Contact information

Practice address
11301 W OLYMPIC BLVD, SUITE 121-435, LOS ANGELES, CA 90064-1653
(424) 256-6682
Mailing address
11301 W OLYMPIC BLVD, SUITE 121-435, LOS ANGELES, CA 90064-1653

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
A68156
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A681560
MEDI-CAL PPIN
CA
Enumeration date
03/27/2017
Last updated
03/27/2017
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