Organization
CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION
Active
Parent organization
CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION
Authorized official
HERBERT MARSHAK MD (MEDICAL DIRECTOR)
(714) 210-8848
Entity
Organization
Contact information
Practice address
1206 E 17TH ST, STE 106, SANTA ANA, CA 92701-2641
(714) 210-8848
Mailing address
2980 N BEVERLY GLEN CIR, STE 100, LOS ANGELES, CA 90077-1726
(310) 474-9809
(888) 431-8819
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
04/19/2011
Last updated
10/05/2015
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