Provider Demographics
NPI:1215444336
Name:INSITE DIGESTIVE HEALTH CARE
Entity type:Organization
Organization Name:INSITE DIGESTIVE HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOAQUIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-937-0275
Mailing Address - Street 1:1010 N CENTRAL AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7320 WOODLAKE AVE STE 310
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1471
Practice Address - Country:US
Practice Address - Phone:818-346-9911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSITE DIGESTIVE HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty