Organization
ALL FAMILY MEDICAL GROUP INC
Active
Other names
FAMILY WELLNESS MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
KAMRAN GHODSIAN MD (PRESIDENT)
(714) 662-1515
Entity
Organization
Contact information
Practice address
220 W 1ST ST STE 102, SANTA ANA, CA 92701-5262
(714) 550-7001
(714) 550-7006
Mailing address
220 W 1ST ST STE 102, SANTA ANA, CA 92701-5262
(714) 550-7001
(714) 550-7006
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0079300
—
CA
01
—
ZZZ55402Z
BLUE SHIELD NUMBER
CA
Enumeration date
08/31/2006
Last updated
10/01/2010
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