OrganizationActive
Acosta Medical Group, Inc.
NPI 1639357114 · Specialist · Glendale, CA
Provider details
- NPI number
- 1639357114
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Malena Wilson, Administrator(818) 240-0601
- License
- G72214 (CA)
Specialties & taxonomies
Other Service Providers
Practice location
222 W Eulalia St
Ste. 201
Glendale, CA 91204-2849
Phone: (818) 240-0601
Fax: (818) 240-0687
Approximate (ZIP-level) locationGet directions
Mailing address
222 W Eulalia St
Glendale, CA 91204-2849
Registry dates
- Enumerated
- 2008-02-06
- Last updated
- 2009-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.