Provider Demographics
NPI:1720578776
Name:FGK MEDICAL CENTER
Entity Type:Organization
Organization Name:FGK MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LI
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-331-6422
Mailing Address - Street 1:327 E. VALLEY BLVD 202
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-6502
Mailing Address - Country:US
Mailing Address - Phone:714-331-6422
Mailing Address - Fax:562-924-8444
Practice Address - Street 1:327 E. VALLEY BLVD 202
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-6502
Practice Address - Country:US
Practice Address - Phone:714-331-6422
Practice Address - Fax:562-924-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty