Organization
AIA PHYSICIANS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EWUNIA GOSEK (MEDICAL DIRECTOR)
(909) 337-5200
Entity
Organization
Contact information
Practice address
971 KUFFEL CANYON RD., SKY FOREST, CA 92385
(909) 337-5200
Mailing address
PO BOX 1502, LAKE ARROWHEAD, CA 92352-1502
(310) 285-1710
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
207R00000X
Internal Medicine Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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