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Organization

MAGELLA MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL R SANTANA (ASSISTANT SECRETARY)
(800) 243-3839
Entity
Organization

Contact information

Practice address
2888 LONG BEACH BLVD STE 400, LONG BEACH, CA 90806-1553
(562) 997-8510
(562) 997-8520
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
207VM0101X
Maternal & Fetal Medicine Physician
Primary
2085R0202X
Diagnostic Radiology Physician
363LW0102X
Women's Health Nurse Practitioner

Other

Enumeration date
09/17/2006
Last updated
10/18/2024
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