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 | 163W00000X Registered Nurse |
207Q00000X Family Medicine | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
104100000X Social Worker | |
1041C0700X Social Worker, Clinical | |
122300000X Dentist | |
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 |