Provider Demographics
NPI:1568085041
Name:INTEGRATED ADVANCED MEDICINE INC
Entity Type:Organization
Organization Name:INTEGRATED ADVANCED MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:AL-SELHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-210-8333
Mailing Address - Street 1:210 S GRAND AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-4282
Mailing Address - Country:US
Mailing Address - Phone:626-335-4466
Mailing Address - Fax:626-335-4476
Practice Address - Street 1:210 S GRAND AVE STE 408
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4282
Practice Address - Country:US
Practice Address - Phone:626-335-4466
Practice Address - Fax:626-335-4476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty