Provider Demographics
NPI:1114656816
Name:JOURNEY HEALTH MEDICAL GROUP OF CALIFORNIA
Entity Type:Organization
Organization Name:JOURNEY HEALTH MEDICAL GROUP OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-674-7967
Mailing Address - Street 1:2415 HIGH SCHOOL AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1879
Mailing Address - Country:US
Mailing Address - Phone:800-674-7967
Mailing Address - Fax:800-674-7967
Practice Address - Street 1:2415 HIGH SCHOOL AVE STE 700
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1879
Practice Address - Country:US
Practice Address - Phone:800-674-7967
Practice Address - Fax:800-674-7967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2023-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty