Provider Demographics
NPI:1063846442
Name:FIG GARDEN MEDICAL GROUP
Entity Type:Organization
Organization Name:FIG GARDEN MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-505-2093
Mailing Address - Street 1:17821 17TH ST STE 250
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2173
Mailing Address - Country:US
Mailing Address - Phone:714-505-2093
Mailing Address - Fax:714-573-0072
Practice Address - Street 1:17821 17TH ST STE 250
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2173
Practice Address - Country:US
Practice Address - Phone:714-505-2093
Practice Address - Fax:714-573-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty