| NPI | 1700439817 |
|---|---|
| Doing Business As | ACTIVE MD MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ARCHANA THUKRAL Administrator 805-501-5715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |