Basic Information
| Provider Information | |||||||||
| NPI: | 1568907178 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONEHEALTH MEDICAL GROUP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 970 | ||||||||
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| City: | PLACENTIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928710970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142237000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2617 E CHAPMAN AVE | ||||||||
| Address2: | STE. 103 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928693226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142237000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2017 | ||||||||
| LastUpdateDate: | 01/05/2017 | ||||||||
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| AuthorizedOfficialLastName: | LAI | ||||||||
| AuthorizedOfficialFirstName: | ALBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7142237000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.