Organization
BASTANCHURY HEIGHTS MEDICAL GROUP, INC.
Active
Other names
Bastanchury Heights Medical Group, Center for Women's Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS THANOS M.D. (PRESIDENT)
(714) 990-2900
Entity
Organization
Contact information
Practice address
2264 N STATE COLLEGE BLVD, FULLERTON, CA 92831-1361
(714) 255-7045
(714) 256-4733
Mailing address
2264 N STATE COLLEGE BLVD, FULLERTON, CA 92831-1361
(714) 255-7045
(714) 256-4733
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0050970
—
CA
Enumeration date
12/12/2006
Last updated
09/20/2010
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