Provider Demographics
NPI:1043647258
Name:PCI MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:PCI MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-462-8181
Mailing Address - Street 1:2151 MICHELSON DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1330
Mailing Address - Country:US
Mailing Address - Phone:714-462-8181
Mailing Address - Fax:888-504-6948
Practice Address - Street 1:2151 MICHELSON DR
Practice Address - Street 2:SUITE 260
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1330
Practice Address - Country:US
Practice Address - Phone:714-462-8181
Practice Address - Fax:888-504-6948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty