Organization
AMERICAN FAMILY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINA R MONROE (OFFICE MANAGER)
(714) 641-0121
Entity
Organization
Contact information
Practice address
2414 S FAIRVIEW ST STE 112, SANTA ANA, CA 92704-5345
(714) 641-0121
(714) 641-2054
Mailing address
2414 S FAIRVIEW ST STE 112, SANTA ANA, CA 92704-5345
(714) 641-0121
(714) 641-2054
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A39997
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740244532
NPI
CA
Enumeration date
03/05/2007
Last updated
11/03/2011
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