| NPI | 1205444742 |
|---|---|
| Doing Business As | ILLUMINATION FOUNDATION MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ERIKA LYNNE SILVER Medical Group Liaison 949-273-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 122300000X Dentist | |
| 163W00000X Registered Nurse | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2021-01-27 |