Provider Demographics
NPI:1790234086
Name:U.S. HEALTHWORKS MEDICAL GROUP OF GEORGIA, INC.
Entity Type:Organization
Organization Name:U.S. HEALTHWORKS MEDICAL GROUP OF GEORGIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:MALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-678-2600
Mailing Address - Street 1:25124 SPRINGFIELD CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1085
Mailing Address - Country:US
Mailing Address - Phone:661-678-2600
Mailing Address - Fax:661-678-2700
Practice Address - Street 1:470 FRANKLIN GTWY SE
Practice Address - Street 2:SUITE 103
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-7739
Practice Address - Country:US
Practice Address - Phone:770-428-8900
Practice Address - Fax:770-426-8444
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S. HEALTHWORKS MEDICAL GROUP OF GEORGIA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty