Provider Demographics
NPI:1750818860
Name:HEALTH LINK MEDICAL GROUP INC
Entity type:Organization
Organization Name:HEALTH LINK MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-721-4000
Mailing Address - Street 1:899 NORTHGATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3667
Mailing Address - Country:US
Mailing Address - Phone:415-223-7504
Mailing Address - Fax:415-223-7505
Practice Address - Street 1:899 NORTHGATE DR STE 400
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3667
Practice Address - Country:US
Practice Address - Phone:415-223-7504
Practice Address - Fax:415-223-7505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH LINK MEDICAL GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty