PROFESSIONAL ADVANTAGE MEDICAL GROUP (NPI# 1639540560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639540560 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL ADVANTAGE MEDICAL GROUP |
| Practice Address |
1041 E Yorba Linda Blvd Suite 203 Placentia CA 92870-3728 |
| Mailing Address |
38713 Tierra Subida Ave Suite 200-315 Palmdale CA 93551-4562 |
| Practice Telephone | 7149859110 |
| Practice Fax Number | 7149859053 |
| Mailing Telephone | 8502332228 |
| Mailing Fax Number | 7149859053 |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-30 |
| Authorized Official Name | JOHN GAMBOL (C.E.O) |
| Authorized Official Telephone | 8502332228 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | G87090 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1041 E YORBA LINDA BLVD SUITE 203 |
| City | PLACENTIA |
| State | CA |
| Zip Code | 92870-3728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689664740 | Tommie's Medical Center Pharmacy | Pharmacist | 1041 E Yorba Linda Blvd, Suite #1, Placentia, CA 92870-3728 | 2005-10-28 |
| 1689198061 | Batal Medical, Inc | Surgery | 1041 E Yorba Linda Blvd, Placentia, CA 92870 | 2017-07-27 |
| 1063947539 | Chest and Critical Care Consultants, A Medical Group | Pediatrics | 1041 E Yorba Linda Blvd, Suite 306, Placentia, CA 92870-3728 | 2017-04-21 |
| 1184088379 | Costa Sports Physical Therapy Inc | Physical Therapist | 1041 E Yorba Linda Blvd, Suite 209, Placentia, CA 92870-3728 | 2016-04-13 |
| 1992166078 | In Hye Oh | Acupuncturist | 1041 E Yorba Linda Blvd, # 310, Placentia, CA 92870-3728 | 2016-03-16 |
| 1043697170 | Westview Clinical Research, LLC | Specialist | 1041 E Yorba Linda Blvd, Suite 210, Placentia, CA 92870-3728 | 2015-04-27 |
| 1174925747 | Nicole Casella | Counselor | 1041 E Yorba Linda Blvd, Placentia, CA 92870 | 2014-09-25 |
| 1790198372 | Diagnostic Medical Solutions | Clinical Medical Laboratory | 1041 E Yorba Linda Blvd, Suite 210, Placentia, CA 92870-3728 | 2014-06-11 |
| 1174933493 | Centers of Rehabilitation & Pain Medicine Inc | Durable Medical Equipment & Medical Supplies | 1041 E Yorba Linda Blvd, Ste 210, Placentia, CA 92870-3728 | 2014-05-08 |
| 1053738575 | National Diagnostics, Inc. | Clinical Medical Laboratory | 1041 E Yorba Linda Blvd, Suite 210, Placentia, CA 92870-3728 | 2014-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952887499 | Makaela Mendelson | Speech-Language Pathologist | 240 South Placentia Avenue, Placentia, CA 92870 | 2018-07-18 |
| 1194186106 | Carrie Schultz | Licensed Vocational Nurse | 543 Del Rey Dr., Placentia, CA 92870 | 2016-03-18 |
| 1710350277 | Caremore Health Plan | Nurse Practitioner | 1325 N. Rose Drive #102, Placentia Linda, CA 92870 | 2015-11-05 |
| 1871999847 | Heather Ellen Johnson | Occupational Therapist | 740 S. Placentia Ave, Suite 100, Placentia, CA 92870 | 2014-11-18 |
| 1992101257 | Arcel Lopez Escoto | Physical Therapist | 740 S. Placentia Ave. Suite 100, Placentia, CA 92870 | 2014-11-14 |
| 1144642109 | Christine Taheran | Nurse Practitioner | 120 Downey Lane, Placentia, CA 92870 | 2014-01-10 |
| 1851644587 | Peter Glickman | Ophthalmology | 1050 E Yorba Linda Blvd., Suite 205, Placentia, CA 92870 | 2012-10-18 |
| 1396003844 | Jaymie Coria, D.d.s., Inc | Dentist | 302 E. Palm Drive, Suite #a, Placentia, CA 92870 | 2012-05-02 |
| 1164798609 | Adelina Rachi | Occupational Therapist | 740 S. Placentia Ave., Suite 100, Placentia, CA 92870 | 2012-03-29 |
| 1023305067 | Patricia Inez Byrne | Registered Nurse | 2001-d E. Orangethorpe Ave., Placentia, CA 92870 | 2011-06-28 |
| Find all providers in zip 92870 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942521174 | Samantha Mekhail Von Ins | General Practice | 1041 E Yorba Linda Blvd Ste 306, Placentia, CA 92870-3751 | 2010-06-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.