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Organization

CAPITAL MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARRD HENRY HUBBARD (PRESIDENT)
(562) 632-1027
Entity
Organization

Contact information

Practice address
440 SHATTO PL, SUITE 419, LOS ANGELES, CA 90020-1793
(562) 632-1027
Mailing address
440 SHATTO PL, SUITE 419, LOS ANGELES, CA 90020-1793
(562) 632-1027

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C31257
CA

Other

Enumeration date
07/26/2016
Last updated
07/26/2016
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