Provider Demographics
NPI:1417209305
Name:SAN GABRIEL VALLEY PHYSICIANS A.C.O. GROUP, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SAN GABRIEL VALLEY PHYSICIANS A.C.O. GROUP, A MEDICAL CORPORATION
Other - Org Name:SAN GABRIEL VALLEY PHYSICIANS ACO MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TOY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:626-208-3988
Mailing Address - Street 1:600 N GARFIELD AVE
Mailing Address - Street 2:307
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1172
Mailing Address - Country:US
Mailing Address - Phone:626-208-3988
Mailing Address - Fax:
Practice Address - Street 1:600 N. GARFIELD AVE
Practice Address - Street 2:307
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1172
Practice Address - Country:US
Practice Address - Phone:626-208-6988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty