| Integrated Allied Medical Group | |
|
313 E Providencia Ave Apt F Burbank CA 91502-2720 | |
| (323) 528-2781 | |
| Not Available |
| Full Name | Integrated Allied Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 313 E Providencia Ave Apt F, Burbank, California |
| Authorized Official Name and Position | Majalia Rivera (CEO) |
| Authorized Official Contact | 3235282781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Allied Medical Group 313 E Providencia Ave Apt F Burbank CA 91502-2720 Ph: (323) 528-2781 | Integrated Allied Medical Group 313 E Providencia Ave Apt F Burbank CA 91502-2720 Ph: (323) 528-2781 |
| NPI Number | 1649970740 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 6204293228 |
|---|---|
| Medicare Enrollment ID | O20230607001430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649970740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amable R Aguiluz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598812596 PECOS PAC ID: 9032000211 Enrollment ID: I20040324001589 |
| Provider Name | Jagmohan Ghotra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689032815 PECOS PAC ID: 8325334741 Enrollment ID: I20160912001816 |
| Provider Name | Eun K Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194226936 PECOS PAC ID: 5698020279 Enrollment ID: I20180622001156 |
| Provider Name | Eusebio Dan P Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962858704 PECOS PAC ID: 1153695663 Enrollment ID: I20181210001783 |
| Provider Name | Katrina Joyce Pacheco Ang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497455760 PECOS PAC ID: 7214394899 Enrollment ID: I20230613002754 |
| Provider Name | Marianne G Usi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104507466 PECOS PAC ID: 2365805017 Enrollment ID: I20230828003263 |
| Provider Name | Conrado A Guadiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942937768 PECOS PAC ID: 2769846948 Enrollment ID: I20230907001538 |
| Provider Name | Marian A Achenie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366937377 PECOS PAC ID: 0042664229 Enrollment ID: I20230921001173 |
| Provider Name | Rowena C Roces |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255014767 PECOS PAC ID: 4587018833 Enrollment ID: I20240119003745 |
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