Organization
SOUTHWIND MEDICAL GROUP
Active
Other names
first advantage medical
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WARREN (PRESIDENT)
(714) 963-0955
Entity
Organization
Contact information
Practice address
17931 EUCLID ST, FOUNTAIN VALLEY, CA 92708-5409
(714) 963-0955
Mailing address
17931 EUCLID ST, FOUNTAIN VALLEY, CA 92708-5409
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A64244
CA
Other
Enumeration date
11/03/2006
Last updated
08/22/2020
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