Provider Demographics
NPI:1184194128
Name:DOWNEY INDUSTRIAL MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:DOWNEY INDUSTRIAL MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:B
Authorized Official - Last Name:TOUCH-BUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-242-2070
Mailing Address - Street 1:11525 BROOKSHIRE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4983
Mailing Address - Country:US
Mailing Address - Phone:562-242-2070
Mailing Address - Fax:562-242-2072
Practice Address - Street 1:11525 BROOKSHIRE AVE STE 202
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4983
Practice Address - Country:US
Practice Address - Phone:562-242-2070
Practice Address - Fax:562-242-2072
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCE-HELENE MARINA RUSSMAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1366659880OtherMEDICAL CLINIC