Organization · Type 2 NPI

Integrative Diagnostic Group Inc

Adult Medicine Physician · Cerritos, CA

NPI number 1104373745 Active

Practice location

12231 Artesia Blvd
Cerritos, CA 90703-2750

Call (562) 653-0180 Map

Fax (562) 402-3029

Mailing address

1231 Artesia Blvd
Cerritos, CA 90703-2750

Specialties and licenses

Taxonomy	Code	License
Adult Medicine Physician Primary	207QA0505X	A30411 (CA)
Psychiatric Residential Treatment Facility	323P00000X	PSY6247 (CA)

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

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NPI record

NPI: 1104373745
Entity type: Organization (Type 2)
Issued: Sep 1, 2016
Last updated: Sep 1, 2016
Status: Active
Subpart: Yes of Integrative Diagnostic Group Inc

Other names

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Integrative Diagnostic Group Inc · other name

Authorized official

Mr. Anil K Ganghi, MD.
President
(562) 653-0180

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About NPI 1104373745

Integrative Diagnostic Group Inc's National Provider Identifier is 1104373745, issued on Sep 1, 2016. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Cerritos, CA. The record was last updated on Sep 1, 2016.