Provider Demographics
NPI:1750712675
Name:ISOS MANAGEMENT GROUP
Entity type:Organization
Organization Name:ISOS MANAGEMENT GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TETREAULT
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:562-217-0316
Mailing Address - Street 1:14454 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2105
Mailing Address - Country:US
Mailing Address - Phone:562-698-2700
Mailing Address - Fax:562-324-6831
Practice Address - Street 1:14454 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2105
Practice Address - Country:US
Practice Address - Phone:562-698-2700
Practice Address - Fax:562-324-6831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty