Provider Demographics
NPI:1225418767
Name:UNITED INTEGRATED MEDICAL CORPORATION
Entity Type:Organization
Organization Name:UNITED INTEGRATED MEDICAL CORPORATION
Other - Org Name:UNITED INTEGRATED HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-280-9968
Mailing Address - Street 1:84 S PALM AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3101
Mailing Address - Country:US
Mailing Address - Phone:626-280-9968
Mailing Address - Fax:877-400-0565
Practice Address - Street 1:84 S PALM AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801
Practice Address - Country:US
Practice Address - Phone:626-280-9968
Practice Address - Fax:877-400-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-30
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFNP545015OtherFICTITIOUS NAME PERMIT