CROSSOVER HEALTH MEDICAL GROUP
Medical Practice at Stanley Tucker Dr, Plum Island, MA

License number
Massachusetts A73842
Category
Medical Practice
Type
Specialist
Owner
Name: ANDREA SULLIVAN M.D
Title: PHYSICIAN
Phone: (949) 891-0328
Address
Address 2
4 Stanley Tucker Dr, Plum Island, MA 01950
26831 Aliso Creek Rd STE 200, Laguna Beach, CA 92656
National Provider ID: 1104264902
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about CROSSOVER HEALTH MEDICAL GROUP at bizstanding.com

CROSSOVER HEALTH MEDICAL GROUP, APC

Laguna Beach, CA  -  San Juan Capistrano, CA

Industry:
Health/Allied Services
Registration:
Jun 4, 2012
Addresses:
65 Enterprise, Aliso Viejo, CA 92656 (Mailing)
26831 Aliso Crk Rd SUITE 200, Aliso Viejo, CA 92656 (Physical)
27101 Puerta Real, San Juan Capistrano, CA 92691
State ID:
0801606798
Business type:
Foreign Professional Corporation
Directors:
Jeff Crichton (Controller), 65 Enterprise, Aliso Viejo, CA 92656,Scott Shreeve (President),Richard Patragnoni Director, inactive
Agent:
Northwest Registered Agent Llc,700 Lavaca, Austin, TX 78701 (Physical)
TIN:
32048151040

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