Organization
TUSTIN PLACE MEDICAL GROUP
Active
Parent organization
TUSTIN PLACE MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
TUSTIN PLACE MEDICAL GROUP
Authorized official
JAYENDRA AMIN M.D. (MEDICAL DIRECTOR)
(714) 838-8254
Entity
Organization
Contact information
Practice address
13095 JAMBOREE RD, TUSTIN, CA 92782-9150
(714) 838-8254
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
10/05/2010
Last updated
03/01/2011
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