Organization
ADVANCED HEALTHCARE ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NELLY BOUTROS (ADMIN)
(714) 317-3044
Entity
Organization
Contact information
Practice address
17220 NEWHOPE ST, 125, FOUNTAIN VALLEY, CA 92708-4272
(714) 435-0600
(714) 960-8007
Mailing address
17220 NEWHOPE ST, 125, FOUNTAIN VALLEY, CA 92708-4272
(714) 435-0600
(714) 960-8007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A47792
CA
207R00000X
Internal Medicine Physician
G32104
CA
207RP1001X
Pulmonary Disease Physician
A37535
CA
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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