Organization
ACESSMD MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEL A BOUTROS MD (PRESIDENT)
(714) 317-3084
Entity
Organization
Contact information
Practice address
17220 NEWHOPE ST, #125, FOUNTAIN VALLEY, CA 92708-4272
(714) 435-0600
Mailing address
PO BOX 8095, FOUNTAIN VALLEY, CA 92728-8095
(949) 951-9399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A47792
CA
207R00000X
Internal Medicine Physician
G32104
CA
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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