| Orange County Gastroenterological Medical Group Incorporated | |
|
3055 W Orange Ave Ste 105 Anaheim CA 92804-3152 | |
| (714) 995-4704 | |
| (714) 995-3814 |
| Full Name | Orange County Gastroenterological Medical Group Incorporated |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 3055 W Orange Ave Ste 105, Anaheim, California |
| Authorized Official Name and Position | Kenneth M Yamashiro (OWNER) |
| Authorized Official Contact | 7149954704 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange County Gastroenterological Medical Group Incorporated 3055 W Orange Ave Ste 105 Anaheim CA 92804-3152 Ph: (714) 995-4704 | Orange County Gastroenterological Medical Group Incorporated 3055 W Orange Ave Ste 105 Anaheim CA 92804-3152 Ph: (714) 995-4704 |
| NPI Number | 1770632234 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770632234 | NPI | - | NPPES |
| 1843815 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G13929 (California) | Primary |
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