Provider Demographics
NPI:1144786831
Name:VIRGINIAS TOTAL CARE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:VIRGINIAS TOTAL CARE MEDICAL GROUP INC
Other - Org Name:VIRGINIAS TOTAL CARE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARRAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-281-8835
Mailing Address - Street 1:850 S ATLANTIC BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4729
Mailing Address - Country:US
Mailing Address - Phone:626-281-8835
Mailing Address - Fax:626-281-1526
Practice Address - Street 1:850 S ATLANTIC BLVD
Practice Address - Street 2:STE 300
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4729
Practice Address - Country:US
Practice Address - Phone:626-281-8835
Practice Address - Fax:626-281-1526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty