| Optimum Wellness Medical Group | |
|
1030 S Glendale Ave Suite 503 Glendale CA 91205-5612 | |
| (818) 547-5400 | |
| (818) 547-3380 |
| Full Name | Optimum Wellness Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1030 S Glendale Ave, Glendale, California |
| Authorized Official Name and Position | Grayce Megan Shields (PRESIDENT) |
| Authorized Official Contact | 8185475400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Wellness Medical Group 1030 S Glendale Ave Suite 503 Glendale CA 91205-5612 Ph: (818) 547-5400 | Optimum Wellness Medical Group 1030 S Glendale Ave Suite 503 Glendale CA 91205-5612 Ph: (818) 547-5400 |
| NPI Number | 1053593731 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 12/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053593731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G35611 (California) | Primary |
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