Organization
CENTERS FOR FAMILY MEDICINE GP
Active
Other names
OPTUMCARE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR)
(702) 480-2550
Entity
Organization
Contact information
Practice address
3460 KATELLA AVE, LOS ALAMITOS, CA 90720-2334
(562) 594-6599
(562) 598-6220
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 480-2550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
01/29/2007
Last updated
08/02/2024
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