Organization
ADELANTE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL PENUNURI M.D. (MEDICAL DIRECTOR)
(714) 541-6009
Entity
Organization
Contact information
Practice address
1840 S STANDARD AVE, SUITE #108, SANTA ANA, CA 92707-2464
(714) 541-6009
Mailing address
1840 S STANDARD AVE, SANTA ANA, CA 92707-2464
(714) 514-6009
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
G50737
CA
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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