Provider Demographics
NPI:1588755326
Name:U.S. HEALTHWORKS MEDICAL GROUP -SAUGUS
Entity type:Organization
Organization Name:U.S. HEALTHWORKS MEDICAL GROUP -SAUGUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-565-1300
Mailing Address - Street 1:22840 SOLEDAD CANYON ROAD
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:CA
Mailing Address - Zip Code:91350
Mailing Address - Country:US
Mailing Address - Phone:661-799-1776
Mailing Address - Fax:661-799-1775
Practice Address - Street 1:22840 SOLEDAD CANYON ROAD
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:CA
Practice Address - Zip Code:91350
Practice Address - Country:US
Practice Address - Phone:661-799-1776
Practice Address - Fax:661-799-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A28257Medicare UPIN
W10051AMedicare ID - Type Unspecified