Organization
INTEGRATED MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES SIMBULAN (CEO)
(818) 224-9390
Entity
Organization
Contact information
Practice address
208 E CARSON ST STE 101, CARSON, CA 90745-2762
(818) 224-9390
(818) 938-1538
Mailing address
8622 RESEDA BLVD STE 200, NORTHRIDGE, CA 91324-4091
(818) 224-9390
(818) 938-1538
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
C3565047
CA
Other
Enumeration date
06/12/2013
Last updated
06/19/2016
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