Organization
DRLAVIDA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN ANH PHUNG (PRESIDENT)
(213) 321-4125
Entity
Organization
Contact information
Practice address
101 E BEVERLY BLVD STE 201, MONTEBELLO, CA 90640-4315
(213) 321-4125
(805) 253-7186
Mailing address
101 E BEVERLY BLVD STE 201, MONTEBELLO, CA 90640-4315
(213) 321-4125
(805) 253-7186
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
01/12/2021
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