| NPI | 1104373745 |
|---|---|
| Other Name | INTEGRATIVE DIAGNOSTIC GROUP INC |
| Entity Type | Organization |
| Authorized Contact | ANIL K GANGHI President 562-653-0180 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A30411) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: CA PSY6247) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |