| Agile Occupational Medicine, Pc | |
|
15401 S Main St Gardena CA 90248-2214 | |
| (310) 403-1491 | |
| Not Available |
| Full Name | Agile Occupational Medicine, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15401 S Main St, Gardena, California |
| Authorized Official Name and Position | Gregory Moore (CEO) |
| Authorized Official Contact | 3104031491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agile Occupational Medicine, Pc 3200 Bristol St Ste 600 Costa Mesa CA 92626-1810 Ph: (844) 207-8321 | Agile Occupational Medicine, Pc 15401 S Main St Gardena CA 90248-2214 Ph: (310) 403-1491 |
| NPI Number | 1992375133 |
|---|---|
| Provider Enumeration Date | 06/29/2021 |
| Last Update Date | 07/20/2022 |
| Medicare PECOS PAC ID | 2567809957 |
|---|---|
| Medicare Enrollment ID | O20240320003959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992375133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QX0100X | Clinic/center - Occupational Medicine | (* (Not Available)) | Primary |
| Provider Name | Soheil S Younai |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1770694069 PECOS PAC ID: 0446202113 Enrollment ID: I20090107000606 |
| Provider Name | Alarick K Yung |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1780646372 PECOS PAC ID: 5395743330 Enrollment ID: I20090309000502 |
| Provider Name | Minh Q Nguyen |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1336111251 PECOS PAC ID: 9537463054 Enrollment ID: I20190405000455 |
| Provider Name | Alexander David Neusner |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1528404993 PECOS PAC ID: 3870886120 Enrollment ID: I20230824000452 |
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