Provider Demographics
NPI:1285169748
Name:MEDICOR INC
Entity type:Organization
Organization Name:MEDICOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CHAN
Authorized Official - Last Name:LUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-856-8052
Mailing Address - Street 1:PO BOX 1390
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91077-1390
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-623-1227
Practice Address - Street 1:501 S BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:818-847-4010
Practice Address - Fax:818-847-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty