Organization
CONCENTRA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY MYRON FULLER PTA (PHYSICAL THERAPIST ASSISTANT)
(714) 522-8051
Entity
Organization
Contact information
Practice address
26 CENTERPOINTE DR, 115, LA PALMA, CA 90623-1072
(714) 522-8051
(714) 522-5703
Mailing address
26 CENTERPOINTE DR, 115, LA PALMA, CA 90623-1072
(714) 522-8051
(714) 522-5703
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
AT3551
CA
Other
Enumeration date
05/17/2007
Last updated
08/22/2020
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