Provider Demographics
NPI:1225695422
Name:CONCERTOHEALTH OF OHIO LLC
Entity Type:Organization
Organization Name:CONCERTOHEALTH OF OHIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:877-597-1440
Mailing Address - Street 1:85 ENTERPRISE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2614
Mailing Address - Country:US
Mailing Address - Phone:949-407-2141
Mailing Address - Fax:949-407-2010
Practice Address - Street 1:85 ENTERPRISE STE 200
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2614
Practice Address - Country:US
Practice Address - Phone:877-597-1440
Practice Address - Fax:949-407-2010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONCERTOHEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty