NPI 1023511045
Performance Health Medical Group
Practice location
- Address
- 25431 Cabot Road Suite 118, Laguna Hills, CA 92653
- Phone
- (479) 636-9702
- Fax
- (877) 427-2307
- Mailing address
- PO Box 3328, Bentonville, AR 72712
Authorised official
- Name
- Amanda Gonzalez
- Title
- Ncpdp Coordinator
- Phone
- (479) 636-9702
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1023511045
- Entity type
- Organization
- NPI issued
- 15 Mar 2018
- Record last updated
- 15 Mar 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.