Provider Demographics
NPI:1881623734
Name:IGO MEDICAL GROUP AMC
Entity type:Organization
Organization Name:IGO MEDICAL GROUP AMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-455-7520
Mailing Address - Street 1:9339 GENESEE AVENUE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2121
Mailing Address - Country:US
Mailing Address - Phone:858-455-7520
Mailing Address - Fax:585-554-1312
Practice Address - Street 1:9339 GENESEE AVENUE
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2121
Practice Address - Country:US
Practice Address - Phone:858-455-7520
Practice Address - Fax:585-554-1312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty